眶隔脂肪游离移植填充眶下缘凹陷在下睑整形术中的应用

The Free Transposition of Orbital Fat to Treat Infraorbital Depression in Lower Blepheroplasty

目的:探讨眶隔脂肪游离移植填充眶下缘凹陷应用于下睑整形术中的有效性和可行性。方法:对2016年1月-2018年1月笔者医院收治的36例下睑松弛患者进行回顾性研究,均为泪沟和眶颧沟明显的患者,采用常规皮肤入路行下睑松弛矫正术,术中将内、中、外三团眶隔脂肪切除后,游离移植于眶下缘凹陷区域,并用5-0 PDS线牵引固定到皮肤外。对患者的术后效果,患者满意度和手术并发症情况进行评价。结果:所有患者术后切口愈合良好,无一例发生术区感染。5例患者(13.9%)术后早期发生轻度下睑退缩,8例(22.2%)早期眶下缘可触及硬结,上述两种并发症经局部热敷、按摩后于3个月以内消失。术后6个月共有28例患者来院复诊,患者满意度平均评分为3.3分,总体评价为满意。结论:对于眶下缘萎缩,泪沟和眶颧沟明显的患者,在下睑整形术中,采用眶隔脂肪游离移植填充可以有效矫正眶下缘凹陷,使泪沟和眶颧沟不明显,效果稳定满意。

Objective To explore the effect and feasibility of the orbital fat free transposition to treat infraorbital depression in the lower blepheroplasty.Methods Thirty-six patients with loewer eyelid laxity and tear trough/orbitalmalar sulcus deformity in the author’s hospital from January 2016 to January 2018 were selected as research subjects.Through the transcutaneous lower blepheroplasty,the orbital fats were dissected directly and transposed to the depression inferior to the orbital rim.The free orbital fat grafts were fastened with 5-0 PDS suture,penetrated through the skin and fixed with sterile 3M tape.The post-operative effect,patient satisfaction and complications were evaluated.Results All the patient wounds healed uneventfully.No infection occurred.The slight lower lid retraction was seen in 5 patients(13.9%)and the nodules were touched below the inferior orbital rim in 8 patients(22.2%)at the early stage of the post-operation.After massaging and heat compressing,the lower lid retraction and touching nodules disappeared spontaneously.At the consultation 6 months after operation,the mean point of the patients satisfying score was 3.3.The results of surgery were excellent.Conclusion The transposition of free orbital fat graft could correct the infraorbital depression effectively.When combined with the lower blepheroplasty,the results of the surgery were excellent.