内切口骨膜下平面剥离眶隔脂肪下置矫治泪沟型睑袋

Clinical Study of Subperiosteal Dissection and Orbital Septum Fat Redistribution through Transconjunctival Incision in Lower Blepharoplasty

目的:探索内切口骨膜下平面剥离眶隔脂肪下置治疗泪沟型睑袋的临床效果。方法:2016年6月-2018年12月治疗泪沟型睑袋116例,采取激光下睑结膜切口,于眼轮匝肌深面及眶隔浅面之间分离,直至弓状缘,10W超脉冲激光打开弓状缘眶骨膜,在骨膜下平面向下剥离至泪沟下缘,约10~15mm,将膨出的眶隔脂肪向下平铺于眶骨表面,末端缝合固定于骨膜及深筋膜最远端。结果:随访6个月,110例表示满意,睑袋及泪沟获得完全矫正;5例表示基本满意;1例不满意。术后无血肿、睑外翻、下睑退缩、下睑凹陷、下睑不平整等并发症发生。结论:内切口骨膜下平面剥离眶隔脂肪下置治疗泪沟型睑袋,是一种良好的睑袋整形手术方法。

Objective To explore the clinical effi cacy of subperiosteal dissection and orbital septum fat redistribution through transconjunctival incision in lower blepharoplasty.Methods From June 2016 to December 2018,116 patients with lower eyelid pouch and tear trough deformity received lower blepharoplasty,except for those with noticeable loose skin.The conjunctiva was opened by laser.The gap between deep orbicularis and superfi cial orbital septum was separated,until the arcuate margin was reached.The orbital periosteum at the arcuate margin was opened by 10W ultra pulse laser,and it was dissected to the inferior margin of tear trough deformity under the periosteum,about 10-15mm.The bulging orbital septum fat was tiled down on the surfi cial orbital bone,and the ends were sutured and fi xed to the farthest of the periosteum and deep fascia.Results During a follow-up of 6 months,110 patients were satisfi ed with lower eyelid pouch and tear trough deformity disappeared.5 patients were basically satisfi ed and one case was unsatisfi ed.There were no complications such as hematoma,ectropion,retraction,depression,unevenness.Conclusion Subperiosteal dissection and orbital septum fat redistribution through transconjunctival incision in lower blepharoplasty is a good method.