眶隔翻转向下固定仿生法重睑成形术

Double-eyelid blepharoplasty by turning the orbital septum downward

目的探讨眶隔翻转向下固定仿生法重睑成形术的临床效果.方法2015年12月至2018年2月,对就诊于湖南省人民医院的311例患者(男25例,女286例,年龄17~65岁),采用眶隔翻转向下固定,仿照生理性力学传导的方法进行重睑成形术.术中横向剪开眶隔,将剪开眶隔的下部以其与上睑提肌筋膜的融合处为蒂,向下翻转下置,与下方眼轮匝肌上缘及其后方睑板前筋膜缝合固定.观察并评价其临床效果.结果本组311例,622只眼,均于术后7d拆线,重睑线形态良好,眼睑闭合良好,随访3个月至1年,外形自然,无上睑退缩,无眼睑闭合不全,未出现切口凹陷性瘢痕,281例达到满意效果,30例为基本满意,无不满意者,满意率为90.4%.结论眶隔翻转向下固定仿生法重睑成形术具有重睑线成形稳定、宽度调节灵活、力学传导形成接近生理性重睑线的优点,具有很好的临床效果.

Objective To investigate a new approach for double-eyelid blepharoplasty. Methods Double-eyelid blepharoplasty was performed by turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia, which is imitating physiological mechanical conduction. During double-eyelid blepharoplasty, the orbital septum was cut horizontally. Using the fusion of the levator aponeurosis with septum as a pedicle, the lower part of the orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the outcomes of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to February 2018. Results 622 eyes of 311 patients were included in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid lines were well-formed, and the eyelids closed well. Three-to twelve-month follow-up results revealed that the double-eyelid shape was natural, no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. 281 patients were fully satisfied with the surgical results and 30 were basically satisfied with the surgical results. Conclusions Turning the orbital septum downward is a good approach for double-eyelid blepharoplasty.