眶隔脂肪释放联合眼轮匝肌固位结构松解术在睑袋整复术中的应用

Application of orbital fat combined with retaining structure loosening in correcting eye pouch

目的 探讨眶隔脂肪释放联合眼轮匝肌固位结构松解术改善睑袋的临床效果。方法 30例下睑眼袋合并泪沟畸形采用眶隔脂肪释放＋眼轮匝肌固位结构松解手术。术中在分离眶下缘以下浅面骨膜后,先行释放并转移眶隔脂肪矫正泪沟畸形,然后松解部分眼轮匝肌固位结构,并行下睑软组织上提及固定。结果 术后随访6-12个月,术区肿胀时间约1个月,未发生下睑外翻、睑球分离等并发症;1例因术后泪沟无明显改善,后经再次脂肪注射后泪沟消失,其余患者睑袋及泪沟消失。结论 采用眶隔脂肪释放联合眼轮匝肌固位结构松解术治疗睑袋安全、有效,并发症少。

Objective To investigate the combination application of orbicularis retaining structure loosing and orbital fat releasing in correcting eye pouch. Methods Thirty cases of lower eyelid pouch with tear trough deformity received orbital fat releasing and orbicularis retaining structure loosening operation. After superficial separation of periosteum below the inferior orbital margin, orbital fat was released to fill tear trough. Orbicularis retaining structure was then loosened. The soft tissue of the lower eyelid was lifted and fixed. Results All patients were followed up for 6 to 12 months postoperatively. Apparent swelling period was about one month. No major complications as ectropion and eyelid separation occurred. The eye pouch and tear trough disappeared in all patients except one patient who got satisfied after the second injection. Conclusion Lower eyelid blepharoplasty combined with orbicularis retaining ligament loosening and orbital fat releasing is a safe and effective method, with less complications.