眶隔重置及外眦固定在眼袋整复中的临床观察

Clinical Observation of Orbital Replacement and Outer Canthus Fixation on Pouch Reconstruction

目的:探讨应用眶隔脂肪在泪沟填充和外眦固定的手术效果。方法:经下睑睫毛下缘2~3mm作切口,将眶隔完整分开,适当去除一部分脂肪,把多余脂肪平铺于泪沟位置,眶隔下缘固定于眶缘下3~5mm的骨膜上;切口外延长线下方切断的部分眼轮匝肌悬吊于眶骨外侧缘骨膜上。结果:本组共128例患者,其中2例患者早期外眦固定处有轻微硬结,3个月后症状消失,其余患者均一期愈合。术后随访3~12个月,下睑皮肤均平展,紧致,切口愈合良好,痕迹极其不明显,无睑缘退缩,效果满意。结论:眶隔脂肪释放有效的解决泪沟凹陷,使眶周年轻化;肌皮瓣在外眦固定能有效的加快恢复,减轻术后并发症,有效减少睑袋外翻,下睑缘退缩的较好方法。

Objective:To explore the effect of orbital fat filling the tear trough and fixing the orbicularis flap to the outer canthus. Method:The incision waw made under lower eyelid margin 2~3mm and then separated the orbital septum completely.Part of orbital fat was removed,and the remaining was released into the tear trough. The part of the lateral incision orbicularis oculi flap was fixed to the external orbital bone periosteum. Result:Two cases in the group of 128 patients had found mild induration in early outer canthus. However,the symptoms disappeared completely after three months. The remaining patients healed well. Patients were followed up for 3~12 months. Lower eyelid skin was flat and compact and healed well,with no obvious scars and no eyelid retraction. Conclusion:Orbital fat releasing can effectively solve the tear trough and resulting in peri-orbital rejuvenation. Muscle flap fixed to the lateral orbital bone periosteum is a better way for improving recovery and reducing postoperative complication.