多元化切口个性化矫正老年性上睑皮肤松弛

Personalized surgical corrections of upper eyelid blepharochalasis in the elderly through diversified incisions

目的研究多元化切口、个性化矫正老年性上睑皮肤松弛的手术方法以期获得最佳临床矫正效果。方法按照老年人不同的个人意愿,依据眉的位置和形态、睑缘位置及上睑提肌肌力、上睑臃肿及凹陷、眼睑的皱纹等,选择多元化切口和有针对性术式,并对其临床疗效进行总结分析。结果 91例(182只眼)患者随访3个月以上者85例。满意者共70例,占82.35%;较满意者共12例,占14.12%,其中4例眉上切口瘢痕评分>1分,1例眉尾下垂,术后重睑线不流畅1例,4例重睑皱褶不对称,2例上睑皮肤松弛改善不明显;不满意者共3例,占3.53%,其中2例眉上瘢痕评分>1分,1例重睑皱褶不对称。满意率为96.47%。结论对老年性上睑皮肤松弛的患者,应采用多元化切口,根据个性化特点和个人意愿,选择适合的切口和术式,不仅改善了患者症状,同时也获得令人满意的美容效果。

Objective To explore an effective surgical method for personalized surgical correction of upper eyelid blepharochalasis in the elderly using diversified incisions.Methods Surgical incisions and method were chosen based on personal characteristics and willingness, the location and symmetry of the eyebrow, position of eyelid margin and muscle strength of levator muscle of upper eyelid, swollen or hollow of the upper eyelid, wrinkles of the eyelids and so on. The clinical effect was summarized and analyzed. Results Of the 91 cases, 85 cases were followed up for more than 3 months. 70 cases(82.35%) were very satisfied;12 cases(14.12%) were satisfied, of whom 4 cases had an eyebrow incision scar score >1, 1 case had droopy eyebrow tail, 1 case had unsmooth double eyelid line, 4 cases had asymmetry of double eyelid fold, and 2 cases had unsatisfactory improvement in upper eyelid skin flaccidness. 3 cases(3.53%) were unsatisfied, of whom 2 cases had an eyebrow incision scar score >1 and 1 case had asymmetry of double eyelid fold. The overall satisfaction rate was 96.47%. Conclusions Surgical correction approaches of upper eyelid blepharochalasis in the elderly should be selected according to the individual characteristics and willingness and apply diversified incision, which can not only improve the symptoms of the patients, but also bring satisfactory cosmetic effects.