经结膜入路眶隔脂肪重置内固定术矫正睑袋伴泪沟畸形

Transconjunctival orbital fat repositioning and internal fixation in the correction of eyelid bag and tear trough deformity

目的探讨经结膜入路眶隔脂肪重置内固定术矫正睑袋伴泪沟畸形的临床应用效果。方法回顾性分析2020年6月至2021年5月,空军军医大学第一附属医院整形外科采用经结膜入路眶隔脂肪重置内固定术矫正睑袋伴泪沟畸形的57例患者的临床资料。术中经下睑结膜切口将眶隔脂肪瓣在眶下缘内侧及中外侧分别于上颌前间隙基底及颧脂肪垫上极缝合固定矫正睑袋伴泪沟畸形。术后6个月评估患者满意度并比较手术前后效果差异。结果57例患者获随访6~12个月,术后泪沟分型情况明显优于术前,其差异有统计学意义(P<0.05)。术后6个月总体满意度评分为(4.368±0.919)分,Ⅲ级泪沟组满意度显著高于Ⅰ级及Ⅱ级泪沟组,且Ⅰ、Ⅱ组组间满意度差异无统计学意义(P>0.05)。不同泪沟分型组患者术后6个月泪沟情况无明显差异。结论经结膜入路眶隔脂肪重置内固定术对于下睑牵拉活动度好的患者是一种安全有效的矫正睑袋合并泪沟畸形的方法,填充效果确切、持久。

Objective To explore the clinical efficacy of transconjunctival orbital fat repositioning and internal fixation in the correction of eyelid bag and tear trough deformity.Methods The clinical data of 57 patients with eyelid bags and tear trough deformity treated in the Department of Plastic Surgery from June 2020 to May 2021 were retrospectively analyzed.During the operation,the orbital septum fat flap was sutured and fixed at the base of the anterior maxillary space and the superior pole of the malar fat pad through the lower eyelid conjunctival incision to correct eyelid bag and tear trough deformity.At 6 months after operation,patient satisfaction was evaluated and the appearance before and after operation was compared.Results All patients were followed-up for 6 to 12 months.The classification of tear trough after operation was significantly better than that before operation,and the difference was statistically significant(P<0.05).At6 months after operation,the overall satisfaction score was(4.368±0.919).The satisfaction of grade Ⅲ tear trough group was significantly higher than that of grade Ⅰ and Ⅱ group,and there was no significant difference between grade Ⅰ and Ⅱ group(P>0.05).There was no significant difference in tear trough among different groups at 6 months after operation(P>0.05).Conclusion Transconjunctival orbital fat repositioning and internal fixation is a safe and effective method in the correction of eyelid bag and tear trough deformity.