眶隔缩紧在改善睑袋整复效果中的作用

The roles of tightening of orbital septum in improving the cosmetic results of lower eyelid blepharoplasty

目的 评价缩紧眶隔在提高睑袋整复效果中的作用。方法 ①采用经皮肤入路下睑成形术切口 ,在眼轮匝肌与眶隔之间剥离至眼轮匝肌下缘 ,形成皮肤 -肌肉瓣。②向下牵拉皮肤 -肌肉瓣 ,显露眶隔与眶下缘。③沿眶下缘剪开眶隔 ,释放眶内脂肪 ,如眶内脂肪过多 ,可做部分切除。④将眶隔下缘连带眶脂肪下缘缝合固定于眶下缘下方 3～ 5mm处的骨膜上 ,以缩紧眶隔和填充眶下缘前方的凹陷区。⑤切除多余的皮肤与肌肉 ,缝合切口。结果 自 1999年以来 ,共施术 5 2例 ,其中 2 7例患者随访 3～ 12个月 ,除 1例术后因发生下睑退缩做第 2次手术矫正外 ,其余均获得满意的美容效果。结论 眶隔紧缩对提高睑袋整复的美容效果具有重要作用和意义 。

Objective To evaluate the role of tightening of orbital septum in improving the result of lower eyelid blepharoplasty. Methods Through a transcutaneous lower lid blepharoplasty incision, dissection was carried between orbital septum and orbicularis oculi muscle to the inferior border of the orbicularis muscle. The muscle-skin flap was pulled downwards for exposing orbital septum and infraorbital rim. The orbital septum was opened widely along the arcus marginalis for releasing the orbital fat. Some orbital fat was removed if it was excessive, then the inferior edge of the septum including orbital fat was reset over the inferior orbital rim with 5-0 sutures. Finally the excessive skin and muscle was removed, and the incision was sutured. Results Since 1999, a total of 52 patients underwent this procedure. Among these 52 patients, 27 were available for 3 to 12 month′s follow-up. All patients were quite satisfied with the cosmetic result except one who developed lower lid retraction and was corrected by the second operation. Conclusion Tightening of the orbital septum plays an important role in improving the cosmetic result of lower lid blepharoplasty, and it should be regarded as a significant step in lower lid blepharoplasty.