单眼三点小切口重睑成形术的临床效果

Clinical effects of small-incision orbicularis-levator fixation technique for monocular double-eyelid blepharoplasty

目的探讨单眼三点小切口眼轮匝肌-提上睑肌固定法重睑成形术的临床效果。方法对美容就医者行单眼小切口眼轮匝肌－提上睑肌固定法重睑成形术，通过重睑线位置设定、软组织去除量、小切口数量和位置、术中缝线固定张力达到与另眼重睑形态对称。结果56例均手术顺利，随访（19.3±3.4）个月，术前及术后6个月行上睑磁共振成像（MRI），测量上睑软组织厚度（睑部眼轮匝肌、眶部眼轮匝肌和眶隔脂肪截面积）。术前睑部眼轮匝肌厚度：左眼（4.08±0.74） U（1U＝0.4464 mm），右眼（4.81±1.05） U（t＝2.66，P〈0.05）；眶隔脂肪截面积：左眼（84.26±9.75） U2，右眼（93.85±12.15） U2（t＝3.21，P〈0.05）。术后睑部眼轮匝肌厚度；左眼（4.07±0.69 ） U，右眼（4.37±0.99 ） U（t＝1.46，P＝0.15）；眶隔脂肪截面积：左眼（82.88±8.81） U2，右眼（85.30±11.94 ） U2（t＝1.21，P＝0.23）。54例术后对称满意，1例术后重睑变窄，1例重睑线消失。结论单眼三点小切口眼轮匝肌-提上睑肌固定法重睑成形术效果好、瘢痕轻微，与另眼基本对称。

ObjectiveTo evaluate the clinical effects of small-incision orbicularis-levator fixation technique for monocular double-eyelid blepharoplasty. MethodsData were collected in 56 patients （5 males and 51 females） with monocular double eyelid from January 2013 to January 2014. All patients underwent small-incision orbicularis-levator fixation blepharoplasty. To ensure the symmetry between the two eyelids, extensive study and design might be done before the surgery, including the positon of incisions, the amount of tissue removed, the tightness of sutures fixation during surgery, and so on. ResultsAll patients were successfully operated and were performed postoperative follow-up for 19.3±3.4 months. MRI was taken on their upper eyelids preoperatively and 6 months postoperatively. Before the surgery, the MRI orbicularis oculi muscle thickness were 4.08±0.74 U in the left side and 4.81±1.05 U in the right （t=2.66, P〈0.05）; the areas of orbit fat were 84.26±9.75 U2 in the left and 93.85±12.15 U2 in the right （t=3.21, P〈0.05）. As for 6 months postoperatively, the MRI orbicularis oculi muscle thickness were 4.07±0.69 U in the left side and 4.37±0.99 U in the right （t=1.46, P=0.15）; the areas of orbit fat were 82.88±8.81 U2 in the left and 85.30±11.94 U2 in the right （t=1.21, P=0.23）. Fifty-four patients were satisfied with surgery, the eyelid＇s crease turned narrow in 1 case and disappeared in 1 case. Those 2 cases were adjusted by secondary surgery using the same method. Conclusions Small-incision orbicularis-levator fixation blepharoplasty has a high success rate, with acceptable bilateral symmetry and slight scar.