重睑成形术联合眶隔脂肪移植术在单睑伴轻度上睑凹陷中的应用

Application of blepharoplasty combined with orbital septum fat transplantation in Asians with mild sunken upper eyelid

目的探讨重睑成形术联合眶隔脂肪移植术治疗轻度上睑凹陷的临床效果。方法自2017年7月至2018年10月,中国医学科学院北京协和医学院整形外科医院整形一科对50例患者行重睑成形术联合眶隔脂肪移植术。打开外侧眶隔筋膜,去除适量位于外侧的眶隔脂肪,并予以保留,以7-0缝线行重睑线缝合,根据上睑组织的凹陷程度将去除的脂肪分离成适量大小的脂肪块,通过上睑缝合间隙将脂肪块依次置于重睑线上眼轮匝肌瓣下内中部2/3的区域。结果共45例患者获随访6~18个月,满意率为82%。未发生明显上睑不对称、凹凸不平、凹陷、多重睑等并发症。结论重睑成形术联合眶隔脂肪移植术可有效预防轻度上睑凹陷患者在重睑成形术后出现上睑凹陷和多重睑畸形,值得临床推广应用。

Objective To explore the efficacy of blepharoplasty combined with orbital septum fat transplantation in Asians with mild sunken upper eyelid. Methods From July 2017 to October 2018, 50 patients underwent blepharoplasty combined with orbital septum fat transplantation. The lateral orbital septum fascia was opened and appropriate amount of lateral orbital septum fat was harvested. The double eyelid fold was sutured by 7-0 stitch. The harvested fat was divided into several pieces according to the sunken degree of the upper eyelid. These fat grafts were transplanted under the 2/3 region of the medial-central orbicularis oculi muscle flap through upper eyelid suture space. Results All patients were followed-up for 6 to18 months. The satisfaction rate was 82%. No complications such as obvious asymmetry, irregularities, sunken and multiple upper eyelid folds occurred. Conclusion The blepharoplasty combined with orbital septum fat transplantation is an effective method to prevent sunken upper eyelid and multiple upper eyelid folds in Asians with mild sunken upper eyelid. It should be considerable for clinical promotion and application.