Aim: To determine whether patients with congenital lower lid epiblepharon treated with a modified Hotz procedure combined with epicanthoplasty have a decreased recurrence rate. Patients and Methods: Patients with epiblepharon of the lower eyelid corrected using a modified Hotz method between 2007 and 2017 were evaluated retrospectively by chart review to determine rates of complications and recurrence as well as whether the Hotz method was combined with epicanthoplasty. The recurrence rates for patients treated with the Hotz method alone or in combination with epicanthoplasty were compared. Results: A total of 60 patients (mean age, 13.6 years) and 115 eyelids were evaluated. All patients showed improvement in their symptoms and had no complications. Across the entire group, the recurrence rate for entropion was 23.5% (27 eyes). A modified Hotz procedure combined with epicanthoplasty was performed on 43 (37.4%) eyes. The recurrence rate for the group treated with a modified Hotz procedure combined with epicanthoplasty was significantly lower than that for patients who underwent the Hotz procedure alone (7.0% vs 33.3% P = 0.0012). There was no relationship between epicanthus severity and recurrence rate (P = 0.345). Conclusion: In this study, we showed that patients who underwent a modified Hotz procedure combined with epicanthoplasty had a decreased recurrence rate. This improved outcome could be due to the simpler approach to the nasal side of the lower eyelid in epicanthoplasty, and epicanthoplasty can facilitate detachment of the upper eyelid from the lower eyelid.

Background/Objectives: Temporary decreases in dermal collagen caused by artificial ultraviolet exposure are largely affected by increased epidermis-derived matrix metalloproteinase (MMP)-1 levels. However, the role of epidermal MMP-1 in dermal tissue remodeling induced by chronic sun exposure remains unclear. This study aimed to clarify the involvement of epidermal and dermal MMP-1 in dermal collagen reduction induced by chronic sun exposure. Methods: Immunofluorescent staining of 30 facial skin tissue samples was performed to visualize MMP-1. The fluorescence intensity of epidermal MMP-1 observed on microscopic images was analyzed in relation to the severity of dermal tissue remodeling and the dermal collagen fiber density. A similar correlation analysis of the number of dermal MMP-1-positive cells was also performed. Results: Epidermal MMP-1 was observed in the stratum spinosum of skin without severe tissue remodeling; however, in skin with severe dermal tissue remodeling, MMP-1 was localized throughout the epidermis. The epidermal MMP-1 signal area and dermal collagen fiber density were negatively correlated (ρ = −0.383; p = 0.0002; n = 90). However, the ratio of dermal MMP-1-positive cells to total dermal cells was only negatively correlated with the collagen fiber density in skin that was not severely remodeled (ρ = −0.746; p = 0.001; n = 15). Conclusions: Epidermal MMP-1 is involved in the tissue remodeling of skin that is subjected to chronic sun exposure and short-term ultraviolet radiation exposure. However, dermal-cell-derived MMP-1 may be involved in biological processes that require an immediate collagen degradation response. The results of this study demonstrate the importance of controlling epidermal MMP-1 to inhibit dermal tissue remodeling induced by chronic sun exposure and provide new insights that are beneficial to the development of anti-photoaging skincare cosmetics.

Background: Cartilage harvest and transplantation is a common surgery using costal, auricular, and septal cartilage for craniofacial reconstruction. However, absorption and warping of the cartilage grafts can occur due to inflammatory factors associated with wound healing. Transcription factor nuclear factor-κB (NF-κB) is activated by the various stimulation such as interleukin-1 (IL-1), and plays a central role in the transactivation of this inflammatory cytokine gene. Inhibition of NF-κB may have anti-inflammatory effects. The aim of this study was to explore the potential of an NF-κB decoy oligodeoxynucleotide (Decoy) as a chondroprotective agent. Materials and Methods: Safe and efficacious concentrations of Decoy were assessed using rabbit nasal septal chondrocytes (rNSChs) and assays for cytotoxicity, proteoglycan (PG) synthesis, and PG turnover were carried out. The efficacious concentration of Decoy determined from the rNSChs was then applied to human nasal septal cartilage (hNSC) in vitro and analyzed for PG turnover, the levels of inflammatory markers, and catabolic enzymes in explant-conditioned culture medium. Results: Over the range of Decoy conditions and concentrations, no inhibition of PG synthesis or cytotoxicity was observed. Decoy at 10 μM effectively inhibited PG degradation in the hNSC explant, prolonging PG half-life by 63% and decreasing matrix metalloprotease 3 (MMP-3) by 70.7% (p = 0.027). Conclusions: Decoy may be considered a novel chondroprotective therapeutic agent in cartilage transplantation due to its ability to inhibit cartilage degradation due to inflammation cytokines.

Background/Objectives: In Japan, artificial orbital implants are not approved as medical materials, limiting the number of facilities that perform orbital implant surgery. However, this procedure is crucial for improving the quality of life of ocular prosthesis users by enhancing cosmetic outcomes. This study aimed to evaluate the short-term outcomes of orbital implant surgery using costal cartilage grafts and assess the cosmetic impact by comparing upper eyelid positions between patients who underwent the procedure and those who did not. Methods: Patients were divided into two groups: those who underwent evisceration and orbital implant grafting with costal cartilage (Group 1) and those who used a prosthetic eye without an orbital implant (Group 2). In Group 1 cases, following evisceration, a spherical implant was created using the sixth autologous costal cartilage and covered with four pedicled scleral flaps. The incidence of complications and the necessity for additional surgery were investigated through medical records, and both complications and upper eyelid symmetry were assessed at least 12 months after the final surgical procedure. Results: A total of 23 patients were included: 13 in Group 1 and 10 in Group 2. Group 1 had a significantly lower median age (52 vs. 68 years, p = 0.002) and a higher proportion of females (76.9% vs. 30%, p = 0.024). Upper eyelid asymmetry was significantly greater in Group 2 than in Group 1 (p < 0.05). Orbital fracture was associated with a higher risk of requiring additional surgery (100% vs. 37.5%, p = 0.075), though not statistically significant. Conclusions: Orbital implant surgery with costal cartilage grafts improves eyelid symmetry and cosmetic appearance. Early and accurate orbital volume repair is essential for preventing enophthalmos.