减少眼袋复发的术式选择

Choice of operation type for reducing the recurrent rate of blepharodermachalasis

眼袋的修复以往多是切除松弛的皮肤、眼轮匝肌及膨出的脂肪，而对如何减少眼袋复发的方法很少提及。本组将眼袋分为四种类型，通过不同手术方式，将眼轮匝肌筋膜瓣悬吊固定在外眦眶骨骨膜组织上，使眶隔壁的弹性张力得以加强，术后立位即显下睑区膨隆消失、平坦。随访８８例，最长时间为术后７年，均无复发。

It's generally to repair blepharodermachalasis by resecting relaxed skin, orbicularis muscle and bulgy fat. But this method is not good enough to prevent the relapse of blepharodermachalasis. The paper points out the operative type for preventing the relapse of blepharoderma-chalasis by reinforcing front wall barrier of orbital septum. We classify blepharodermachalasis into four types, and take different operative types accordingly. For type Ⅰ and those between type Ⅰand Ⅱ, we mainly fold up and fix orbicularis muscle fascial flap, and for type Ⅱand Ⅲ, we fix shortened orbicularis muscle fascial flap on the periobital tissue of outer canthus. The ultimate aim of various operative types is to recover springy myodynamia of orbicularis muscle and avoid the relapse of blepharodermachalasis. We performed 286 cases. The bulge were vanished after operation. The best case remained good for 7 years among 88 cases of follow-up survey.