肌皮瓣筋膜层外眦固定下睑袋整复术的临床应用

Clinical application of myocutaneous flap fixed on fascia layer of lateral canthus in correction of baggy deformity of lower eyelid

目的探讨应用肌皮瓣在外眦切口下方眶隔筋膜深层行固定下睑袋整复术的方法及效果。方法于外眦角隐沟内设计切口，在切151外延长线下方切断部分眼轮匝肌并折叠短缩，重新缝合复位两侧断端，悬吊于眶隔筋膜韧带深层。结果本组共137例患者，其中2例患者于术后早期睁眼受限，3个月后症状消失，其余患者均Ⅰ期愈合。术后随访6—12个月，下睑皮肤均平展，切口瘢痕隐蔽，无睑缘退缩，效果满意。结论改良的肌皮瓣筋膜层外眦固定睑袋整复术，能有效地加快恢复，减轻术后并发症，可避免外眦固定术的原有弊端，是治疗下睑松垂的较好方法。

Objective To research the methods and operative effects of correction of baggy deformity of lower eyelid by fixing myocutaneous flap on the deep layer of orbital septum fascia under the lateral canthus incision. Methods The incision was designed in the subsulcus of angulus oculi lateralis, part of the orbicularis muscle was cut and folded for erispation under the extension line outside incision, bilateral ends were sutured and replaced and then they were suspended onto on the deep layer of orbital septum fascia. Results All 137 cases healed primarily except for 2 cases with limited eyes open at the early stage which disappeared at 3 months postoperatively. They were satisfied with flat eyelid skins, concealed incision and non eyelid retraction after 6 - 12 months following up. Conclusion The method of improved myocutaneous flap fixed on deep layer of lateral canthus fascia can speed the patients recovery, decrease the postoperative complications effectively and avoid malpractices of lateral canthopexy. It is a good operative method for treating lower eyelid bag.