眶隔脂肪游离移植在下睑袋整复术中对泪槽畸形的矫正作用

Corrective Effect of Free Orbital Septal Fat Grafting on Tear trough Deformity in Lower Blepharoplasty

目的:探讨在下睑袋整复术中将眶隔脂肪游离移植填充于泪沟处对下睑袋及泪槽畸形的矫正作用。方法:选择2020年6月—2021年6月哈尔滨医科大学附属第二医院整形外科接受诊治的40例下睑袋伴不同程度泪槽畸形患者作为研究对象,所有患者采用经下睑缘切口的下睑袋修复术+眶隔脂肪游离移植填充泪沟术,术后对患者进行随访,观察和评价手术效果,根据术前及术后照片进行对比,采用Likert量表评估手术效果。结果:40例患者术后下睑袋和泪槽畸形改善满意,下睑形态自然,无下睑凹陷和下睑外翻。随访12~24个月,所有患者下睑袋及泪槽畸形无复发,38例(95.0%)患者泪槽畸形陷改善,患者及手术医师对治疗效果满意;另外2例(5.0%)患者泪槽畸形改善欠佳,再次手术给予自体脂肪移植填充泪沟术后达到满意效果。结论:在下睑袋整复术中经下睑缘切口利用眶隔脂肪游离移植对泪槽畸形的矫正,具有操作简单,微创,近期及远期效果好,不易复发以及较少的并发症等诸多优势,可以广泛推广应用于临床。

Objective: To investigate the corrective effect of orbital septal fat grafting in the tear trough on the lower eyelid bag and tear trough deformity during lower eyelid pouch reconstruction. Methods: A total of 40 patients with lower eyelid bags with different degrees of tear trough deformity who received diagnosis and treatment in the hospital from June 2020 to June 2021 were selected as the research subjects. All patients underwent lower eyelid bag repair through lower eyelid margin incision + orbital septal fat grafting to fill tear grooves. Patients were followed up postoperatively. The surgical effect was observed and evaluated. The preoperative and postoperative photos were compared, and the Likert scale was used to evaluate the surgical effect. Results: The lower eyelid bag and tear trough deformity were improved satisfactorily in 40 patients after operation, and the lower eyelid shape was natural without lower eyelid depression and lower eyelid eversion. During the follow-up period of 12-24 months, there was no recurrence of lower eyelid bag and tear trough deformity in all patients. The lacrimal trough deformity was improved in 38 cases(95.0%), and the patients and surgeons were satisfied with the treatment effect. Patients and surgeons were satisfied with the treatment effect. The other 2 cases(5.0%) had poor improvement in tear trough deformity. After reoperation, autologous fat grafting to fill the tear trough achieved satisfactory results. Conclusion: The use of orbital septal fat free grafting to correct tear trough deformity through lower eyelid incision in lower eyelid pouch surgery has many advantages, such as simple operation, minimal invasiveness, good short-term and long-term effects, less recurrence, and fewer complications. It is widely used in clinical practice.