切除眼轮匝肌下脂肪垫在肿泡眼重睑成形术中的应用

Application of resecting partly the suborbicularis ocular fat (SOOF) pads in the procedure of duplication blepharoplasty with the fatty eyelids

目的:通过对眼轮匝肌下脂肪垫(SOOF)的解剖观察,探讨其部分切除在肿泡眼重睑术中的应用效果。方法:对215例肿泡眼施行切开重睑术,在常规切除肥厚的眼轮匝肌和膨隆的眶隔脂肪以减轻上睑臃肿的同时,去除部分上睑外侧肥厚的眼轮匝肌下脂肪垫。结果:临床解剖观察表明眼轮匝肌下脂肪垫在肿泡眼眼睑中较丰富,它位于眼轮匝肌下,覆盖在外侧眶缘上,向外伸展指向眉弓的末端,在眼睑的眶外缘形成檐盖状膨隆,该脂肪垫在上睑外1/3处肥厚更明显,组织较致密。肿泡眼患者重睑术中适当去除部分肌下脂肪垫后上眼睑变薄,重睑弧度自然,形态逼真。术后随访3个月～1年,均获满意效果。结论:只要熟悉眼睑的解剖层次,并谨慎操作,术中适当切除该脂肪垫,可明显提高肥厚眼睑重睑后的美容效果。

Objective To study the anatomy of the suborbicularis ocular fat pads during upper lids and evaluate the clinical effect in the double eyelid procedure. Methods On the basis of upper eyelid anatomy,215 cases with fatty single eyelids were performed with double eyelid blepharoplasty,removing routinely the orbicularis muscles and orbital fats,samely resecting the suborbicularis ocular fat pads in the lower-lateral area of the orbit over zygoma. Results Clinical observations showed that the prominent suborbicularis ocular fat pads reside over the periosteal of the zygoma in the lower-lateral 1/3 area of the orbit,and resection of the fat pads proerply result in imitating natural double eyelids.Postoperative follow-up ranged from 3 months to 1 year,satisfactory result was obtained. Conclusion Only if we have good knowledge about the mechanism of double fold formation and the anatomy of eyelids and do the operation carefully,It will improve the postoperative effect vitally to resect the suborbicularis ocular fat pads in the procedure of duplication blepharoplasty.