Our Summary

This paper discusses a case where a 45-year-old man had serious eye issues and deformities due to a traffic accident. He had a condition called cicatricial conjunctival constriction ring, which made it difficult for him to see and changed the shape of his eyelids. To treat this, the doctors performed a surgery called a Z-plasty, which helped correct the ring constriction. They also used a method called fornix deepening suturing to fix the turned-out eyelid and did a second surgery to correct drooping of the eyelid. Six months after the surgeries, the patient was doing well; his eyes looked symmetrical and normal, and he didn’t have any other issues. The doctors concluded that the Z-plasty surgery was effective in treating this kind of eye problem.

FAQs

  1. What is a Z-plasty surgery and how does it help in treating eye issues?
  2. What is cicatricial conjunctival constriction ring and how does it affect the eyes?
  3. What other methods were used in conjunction with Z-plasty in this case to treat the eye deformities?

Doctor’s Tip

A helpful tip a doctor might give a patient about z-plasty is to follow post-operative care instructions carefully to ensure proper healing and optimal results. This may include keeping the surgical site clean and dry, avoiding excessive strain or movement in the area, and attending follow-up appointments to monitor progress and address any concerns. It is also important to communicate any changes or symptoms to the doctor promptly to prevent complications and promote successful outcomes.

Suitable For

Patients who may be recommended a Z-plasty procedure typically have scar tissue causing functional or aesthetic issues. Some common indications for Z-plasty include:

  1. Scar contractures: Z-plasty can help release tight scar tissue that has formed after burns, trauma, or surgery, allowing for greater range of motion and improved function.

  2. Hypertrophic or keloid scars: Z-plasty can help reduce the size and visibility of raised, thick scars that may be causing discomfort or self-consciousness.

  3. Deformities or abnormalities: Z-plasty can be used to correct asymmetry, malposition, or other aesthetic issues caused by scar tissue or congenital conditions.

  4. Contractures in mucosal tissue: Z-plasty can be used to release tight bands of tissue in areas such as the eyelids, mouth, or genitalia, improving function and appearance.

  5. Closure of wounds in areas of high tension: Z-plasty can be used to redirect tension along natural skin lines, reducing the risk of wound dehiscence and improving healing outcomes.

Overall, Z-plasty is a versatile surgical technique that can be used in a variety of patients to improve both form and function in areas affected by scar tissue or other issues.

Timeline

Before Z-plasty:

  1. Patient experiences a traffic accident which results in serious eye issues and deformities.
  2. Patient is diagnosed with cicatricial conjunctival constriction ring, causing vision impairment and changes in eyelid shape.

After Z-plasty:

  1. Z-plasty surgery is performed to correct the constriction ring.
  2. Fornix deepening suturing is used to fix the turned-out eyelid.
  3. Second surgery is done to correct drooping of the eyelid.
  4. Six months post-surgery, patient’s eyes look symmetrical and normal, with no other issues reported.
  5. Doctors determine that the Z-plasty surgery was effective in treating the eye problem.

What to Ask Your Doctor

  1. What is a Z-plasty surgery and how does it work to correct cicatricial conjunctival constriction ring?
  2. What are the potential risks and complications associated with Z-plasty surgery?
  3. How long is the recovery period after Z-plasty surgery?
  4. Will I need any follow-up appointments or additional surgeries after the Z-plasty procedure?
  5. Are there any alternative treatments or procedures that could be considered for my condition?
  6. What kind of results can I expect from Z-plasty surgery in terms of improving my vision and correcting eyelid deformities?
  7. How experienced are you in performing Z-plasty surgeries for eye conditions?
  8. Can you provide me with before and after photos of previous patients who have undergone Z-plasty surgery for similar issues?
  9. How much will the Z-plasty surgery cost and will my insurance cover it?
  10. Are there any specific post-operative care instructions I should follow to ensure the best outcome from the surgery?

Reference

Authors: Bi X, Sun Y, Fan X. Journal: J Craniofac Surg. 2019 Jul;30(5):1594-1596. doi: 10.1097/SCS.0000000000005366. PMID: 31299776