上睑提肌腱膜在重睑术中的应用

Application of levator aponeurosis in double eyelids operation

目的探讨将皮肤与睑板粘连形成重睑。以达到术后闭眼时留下较明显人工皱褶的目的，使临床效果更加完善。方法沿设计线切开皮肤，在眶隔与上睑提肌腱膜融合部剪开并显露上睑提肌，充分松解上睑提肌腱膜与眶隔筋膜的粘连，使上呤提肌腱膜运动自由，切口下缘眼轮匝肌适当去除，形成重睑时将切口下缘皮瓣与上睑提肌腱膜缝合3针，使得受术者睁闭眼时与上睑提肌一起运动。结果术后随访58例（116只眼睛），睁眼时重睑弧度自然流畅，睫毛微微上翘，闭眼时重睑切口瘢痕不明湿、较平整，无明显皱褶，重睑无“香肠样”外观。结论此方法手术时间短．创伤小，恢复快．重睑术后无“香肠样”外观及闭眼时无明显铍褶，美观逼真，术后外形和功能均令人满意。

Objective To improve an obvious postoperative man-made crease when eyes closed and to achieve the optimal cosmetic and functional results. Methods Exposing and scissoring the leva tor aponeurosis were performed to make it move freely. Fairly infra incision and lower margin orbicularis oculi muscle were cut. The double eyelids were formed by fixing the palpebral dermis of the lower skin flap onto the levator aponeurosis. Results The follow-up of 580 patients （1160 eyes） showed that double eyelid crease were natural and fluent, eyelashes raised slightly, there was no an obvious postoperative man-made crease when eyes closed, and there was no sausage-appearing. Conclusions The method is quick, with minor injury and fast restoration. There is no sausage appearance and an obvious man-made crease when eyes are closed, and so double eyelids are natural and nice, the postoperative results are all aesthetically and functionally pleased.