不同术式眼袋整复术的临床应用

The clinical surgical skills of different types of blepharoplasty

目的探讨不同眼袋整复术的临床适应症及操作要点。方法 178例患者根据临床表现分为单纯眶隔脂肪增多型、眶隔脂肪增多伴下睑皮肤松弛型及下睑皮肤松驰伴眶下缘凹陷型3型,分别采用结膜入路法、皮肤入路法及眶下脂肪释放填充术进行眼袋整复术。结果 178例手术患者,120例随访12个月,114例患者术后下睑眼袋消失,患者自觉满意。其中4例因去除脂肪较少,3月后行结膜入路去除多余脂肪后效果满意;2例患者术后下睑缘不平凹陷,3月后行眶下脂肪释放填充术,术后效果满意;2例患者因术中出血,术后出现下睑皮肤淤青肿胀、下睑缘睑球轻度分离及球结膜下轻度出血,但术后1个月恢复正常效果并自觉满意。结论根据临床分型采取不同的眼袋整复手术方式,治疗效果良好。

Objective To explore the clinical application and operating skills of three types of blepharoplasty.Methods According to lower eyelid manifestation,178 patients were divided into orbital fat herniated type,fat herniated plus skin redundant type and skin redundant plus infraorbital depression type.The three types were performed by conjunctival incision,skin incision and releasing fat in orbital septum with lower pouches taxis operation respectively.Results Among all 178 patients,120 were followed up for 12 months.There were 4 cases of fat removal less-efficiency,2 cases of hollow lower lid sulcus,and 2 cases of postoperative hematoma.They all obtained satisfied appearance after treatment or secondary operation.Conclusion Choosing proper surgical methods of blepharoplasty according to patients' clinical classification can get good healing and beautiful appearance.