改良Park法重睑成形术的效果

Efficacy of modified Park method in blepharoplasty

目的探讨眼轮匝肌-提上睑肌腱膜复合组织瓣(改良Park法)切开重睑术的治疗效果。方法2019年6月至2021年3月,对南京中医药大学附属医院整形外科行重睑成形术患者823例资料进行回顾性分析,其中男92例、女731例,年龄18~45岁(31.4±7.9)岁,伴轻度上睑下垂患者142例。手术均用改良Park法。第三方评估患者术后双侧重睑对称性,测量术前及术后6个月上睑缘角膜映光距离(MRD1),并计算术前与术后MRD1差值(ΔMRD1),统计术后重睑变浅或消失概率。结果823例患者术后切口均一期愈合,随访时间4~22个月,平均10个月。术后双侧重睑对称及基本对称患者764例,占92.8%;不对称患者59例,占7.2%。术后6个月MRD1值较术前明显增加,术前MRD1值为(3.25±0.72)mm,术后6个月MRD1值为(3.64±0.61)mm,ΔMRD1为(0.38±0.76)mm,差异有统计学意义(t=20.41,P<0.05)。术后8例出现重睑线变浅,3例重睑线完全消失。术后患者重睑线弧度自然流畅,睁眼睫毛动感上翘,闭眼上睑皮肤平整,无明显凹陷性瘢痕及睑板前组织臃肿现象。结论改良Park法重睑术可重建重睑外观,形成动态双眼皮。手术方式有较好的对称性、粘连牢固、不易消失,手术同时可矫正轻度上睑下垂。

Objective To investigate the modified application of orbicularis oculi muscle-levator aponeurosis composite tissue flap fixation technique(modified Park method)in double-eyelid surgery.Methods From June 2019 to March 2021,823 patients included 92 males and 731 females,aged from 18 to 45 years with mean(31.4±7.9)years,in which 142 patients with slightly ptosis were selected to receive the treatment in the Department of Plastic Surgery of the Affiliated Hospital of Nangjing University of TCM.The symmetry of bilateral double eyelids after operation was evaluated by the third party.The marginal reflex distance(MRD1)was measured before and 6 months after operation,and the difference between preoperative and postoperative MRD1(ΔMRD1)was calculated.And the postoperative complications were counted.The patients were followed up from 6 to 12 months after surgery to evaluate the long-term results.Results The patients were followed up for 4-22 months(mean 10 months)after operation.And the incisions of all the 823 cases had primary healling.Most patients had smooth upper eyelid crease,upturned lashes and dynamic fold.The skin tended to spread evenly without dimple.The symmetry evaluation by the third party showed that there were 764 patients with symmetry and basic symmetry after operation,the symmetry rate was 92.8%;59 patients with asymmetry,the asymmetry rate was 7.2%.The data of MRD1 increased significantly 6 months after operation,from(3.25±0.72)mm to(3.64±0.61)mm,and theΔMRD1 was(0.38±0.76)mm(t=-20.41,P<0.05).The difference between the two groups was statistically significant.The double eyelid line became shallow in 8 cases and disappeared completely in 3 cases.The double eyelid curve of the patients was natural and smooth after the operation.And there was no obvious sunken scar and pretarsal fullness.Conclusions The"modified Park technique"blepharoplasty can obtain a more firm,symmetrical and natural appearance.And the mild ptosis could be corrected by this method.The anatomical structure can be identified clearly,and the surgical results are highly repeatable.It is worth promoting.