改良肌皮瓣法矫正下睑松弛的疗效

Effect of modified myocutaneous flaps in treatment of lower eyelid relaxation

目的探讨改良肌皮瓣法矫治下睑松弛的疗效。方法2017年6月至2018年11月,武汉爱尔眼科医院眼整形科对下睑松弛85例患者施行改良肌皮瓣法矫正术。男36例,女49例;年龄41~68(45.39±2.97)岁。术中强调保留眼台、泪沟处理技巧、肌肉切除与缝合技巧。随访6个月评价手术满意度。结果术后随访6个月,满意79例,占92.94%;表现为下睑皮肤松弛消失,下睑缘袋状沟消失,无眼睑退缩,睑缘有眼轮匝肌门槛形成,瘢痕不明显。基本满意6例。术后2例患者有轻度睑外翻,术后6个月逐渐恢复。2例外眦切口处发生轻微瘢痕增生。无球后血肿、感染和面神经损伤等并发症,均未进行二次修复手术。结论改良肌皮瓣法矫治下睑皮肤松弛,既兼顾了皮瓣法和肌皮瓣法的优点,又保留了眼台的自然弧度,对下睑皱纹及泪沟有明显的改善作用。

Objective To observe the effect of modified myocutaneous flaps in the treatment of lower eyelid relaxation.Methods From June 2017 to November 2018,85 patients with lower eyelid relaxation were treated in our hospital.Modified musculocutaneous flaps were used in all cases.The techniques of preservation of eye fur,treatment of lacrimal grooves and muscle resection and suture were emphasized during the operation.All patients were followed up for 6 months to observe the occurrence of complications.At 6 months after operation,the satisfaction of operation was evaluated.Results After 6 months of follow-up,79 cases(92.94%)were satisfied.The symptoms included the disappearance of lower eyelid skin relaxation,the disappearance of lower eyelid margin baggy groove,no eyelid retraction,the formation of"orbicularis oculi muscle threshold"on the eyelid margin,and no obvious scar.There were 6 cases of basic satisfaction and 0 cases of unsatisfactory.Two patients had mild eyelid ectropion,2 patients had slight scar hyperplasia at the lateral canthus incision,and no complications such as retrobulbar hematoma,infection and facial nerve injury occurred.No second repair operation was performed.Conclusions Modified musculocutaneous flaps have a satisfactory effect in the treatment of lower eyelid skin relaxation.It not only takes into account the advantages of the two traditional methods of skin flaps and musculocutaneous flaps,but also retains the natural physiological curvature of eye fur.It can also significantly improve the wrinkles and lacrimal grooves of lower eyelid.It is worthy popularizing.