超脉冲CO_(2)点阵激光治疗轻中度眶周老化的效果

treatment of mild to moderate periorbital aging in Asians with ultrapulsed fractional CO2 laser

目的探讨超脉冲CO2点阵激光治疗轻中度眶周老化的效果。方法2018年1—12月,解放军总医院第四医学中心烧伤整形医学部整形修复科将轻中度眶周老化患者36例共72眼(女22例44眼,男14例28眼,年龄26~38岁,平均32.4岁)。将每例患者双眼分至两个组进行自身对照,左右眼随机接受传统手术或光电辅助手术。传统手术组36眼行传统下睑结膜内入路睑袋切除术,光电辅助组36眼行光电辅助的下睑结膜内入路睑袋切除术;两组术后均同期联合点阵激光治疗眶周老化。比较两组手术时间、水肿持续时间、术后并发症情况,术后随访12个月以Barton评分评估患者效果。结果传统手术组术前评估BartonⅠ级11例,疗效评分0.64±0.21;BartonⅡ级25例,疗效评分1.34±0.34。光电辅助组BartonⅠ级17例,疗效评分0.92±0.18;BartonⅡ级19例,疗效评分1.71±0.42。两组BartonⅠ级疗效评分差异有统计学意义(P<0.05);两组BartonⅡ级疗效评分差异有统计学意义(P<0.05)。传统手术组操作时间(16.00±3.75)min,水肿持续时间(7.0±2.4)d;光电辅助组操作时间(12±1.82)min,水肿持续时间(4.0±1.8)d。光电辅助组操作时间和水肿持续时间均少于传统手术组,其差异有统计学意义(P<0.05)。结论超脉冲CO2点阵激光辅助的下睑结膜内入路睑袋切除术操作中无明显出血,术野清晰,操作时间、消肿时间、并发症均明显优于传统手术,可一次性解决睑袋、下睑皮肤松弛、眼周皱纹等症状。此方法值得在轻中度眶周老化患者中应用。

Objective To evaluate the clinical effect of ultrapulse fractional CO2 laser in the treatment of mild to moderate orbital aging in Asians.Methods From January 2018 to December 2018,36 patients(72 eyes)with mild to moderate orbital aging were enrolled,22 women and 14 men,with an average age of 32.4 years.Each patient was randomly divided into two groups.In the traditional operation group,36 eyes received blepharoplasty through traditional inferior conjunctival approach.In the ultrapulsed fractional CO2 laser group,36 eyesunderwent blepharoplasty through the lower eyelid conjunctival approach assisted by optoelectronics.Both groups were treated with ultrapulsed fractional CO2 laser for periorbital aging.The operation time,detumescence time and postoperative complications were compared.At the same time,the periorbital skin relaxation was treated by the combination of the two groups.The patients were followed up for 12 months.Results In the traditional operation group,11 cases were evaluated as Barton gradeⅠpreoperatively,and the efficacy score was 0.64±0.21.In 25 cases of Barton gradeⅡthe efficacy score was 1.34±0.34.17 cases were BartonⅠin photoelectric assisted group,and the efficacy score was 0.92±0.18.In 19 cases of Barton gradeⅡ,the efficacy score was 1.71±0.42.There was a statistically significant difference between the two groups in BartonⅠefficacy score,P<0.05(P=0.016);There was also a statistically significant difference between the two groups in efficacy score of BartonⅡ,P<0.05(P=0.039).The operation time of the photoelectric assisted group was(12.00±1.82)minutes,and the edema duration was(4.0±1.8)days.The duration of operation in the conventional surgery group was(16.00±3.75)minutes,and the duration of edema was(7.0±2.4)days.The operation time and edema duration in the photoelectric assisted group were both shorter than those in the traditional operation group,and the differences were statistically significant(P<0.05).Conclusions The blepharoplasty through traditional inferior conjunctival approach assisted with ultrapulsed fractional CO2 laser has no obvious bleeding,with shorter operation time,swelling reduction time and the number of complications than the traditional operation.This method can solve the symptoms of blepharoplasty,lower eyelid skin relaxation and wrinkles around eyes.This method is worthy of promotion in the treatment of patients with mild to moderate periorbital aging.