一期矫正上睑下垂合并上睑凹陷畸形

One-stage correction of sunken eyes combined with ptosis

目的探讨一期矫正上睑下垂合并上睑凹陷的手术方式及疗效。方法术中根据上睑提肌肌力及上睑提肌腱膜的形态情况，选择上睑提肌腱膜修补术、腱膜折叠、缩短术或联合术式，以调整上睑提肌的肌力及其腱膜与睑板连接状况；同时将眶脂肪移位到凹陷区，或者采集适量自体颗粒脂肪注入至凹陷区的眶脂肪包膜内，复位眶隔膜；最后以常规切开重睑成形术法缝合切口。结果本组15例（30只眼），11例获6—40个月随访，平均9．5个月，上睑下垂矫正满意，未见睑下垂复发，上睑凹陷消失，无并发症，眼部外观及功能恢复正常。结论对上睑下垂合并上睑凹陷的患者，施行自体颗粒脂肪眶脂肪包膜内移植和眶脂肪移位法矫治上睑凹陷，并同期行上睑下垂矫正一期整形，在恢复上睑的解剖结构、正常眼位、运动功能、美化眼外形、趋于年轻化等方面均取得良好的手术效果。

Objective To investigate the technique and therapeutic effect for correction of sunken eyes combined with ptosis. Methods In order to adjust the levator muscle tension and the relationship between levator aponeurosis and tarsus plate, multiple individualized treatment was selected, including levator aponeurosis restoration, levator aponeurosis plication, or shorten, or combination. Then the orbital fat was transferred to the depressed area, or autologous fat particles were collected and injected into the depressed area within the orbital fat fascia. After the orbital septum fascia was restored, the incision was closed primarily. Results 15 cases（30 eyes） were treated. 11 cases were followed up for 6-40 months （ average, 9.5 months） with satisfactory cosmetic and functional result. No recurrence of ptosis happened. Conclusions One-stage correction of sunken eyes combined with ptosis can be achieved with autologous fat injection or orbital fat transposition. Good cosmetic and functional result can be achieved.