眉下皮肤切除术矫正中老年上睑松弛的疗效分析

Infrabrow excision to correct upper eyelid dermatochalasis in middle-aged and elderly patients

目的:评估眉下皮肤切口矫正中老年女性上睑皮肤松弛的疗效、优缺点及适应征。方法:收集就诊于山西省眼科医院的30例上睑皮肤松弛患者。所有患者提上睑肌功能正常(均不伴先天性及获得性上睑下垂),手术主要指征为上睑皮肤松弛,尤其外侧松弛明显30例患者均行眉下皮肤切口手术。评估所有患者手术前后的皮肤松弛程度及手术效果,并观察术后并发症。结果:所有患者均为女性,平均年龄53.20±7.10(40-64)岁,30例患者的上睑皮肤松弛均有效改善。术后1mo,52例效果优,8例效果良。应用客观Strasser系统评价术后1、6mo手术效果,所有患者得分均在0-1分之间,效果优。患者术前不满意的眉毛位置与眉形均有效改善、额纹及鱼尾纹明显减少。所有患者对结果满意。未见伤口裂开、眼睑闭合不全、严重增生性瘢痕等严重并发症发生。结论:眉下皮肤切除术是一种矫正中老年上睑松弛的有效手段。该手术不仅保留了传统上睑成形术的优点,还可以同时改善眉的位置与形态,并可保留眼睑原有形态,术后皮肤瘢痕小、外观良好,满意度高,并发症少。

·AIM:To evaluate the effects,advantages,disadvantages,and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women.·METHODS:Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018.All patients had upper eyelid dermatochalasis,and the functions of their levator palpebrae were all normal.The primary indications of the procedure were upper lid dermatochalasis with lateral hooding.All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital.The degree of skin relaxation before and after surgery was evaluated in all patients,and surgical outcomes and postoperative complications were also assessed.·RESULTS:All patients were female,ranging from 40 to 64(mean:53.20±7.10)years old.Skin relaxation of the upper eyelid was improved in all 30 patients.One month after the operation,52 lids(86.7%)showed good results and 8 lids(13.33%)showed fair results.The objective Strasser system was applied to evaluate surgical results at 1 and 6mo.All patients had scores between 0 and 1 point,indicating good results.Preoperative unsatisfactory position and shape of the eyebrows were improved,and crow’s feet and frontal lines were reduced.All patients were satisfied with the results.No complications related to wound dehiscence,lagophthalmos,or hypertrophic scars were observed.·CONCLUSION:Infrabrow skin excision is a simple,useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry.This procedure not only retains the advantages of classic blepharoplasty,but also alleviates many eyebrow problems at the same time,and maintains the original shape of the eyelid,minimizes scarring,and produces a smoother,more youthful appearance.