睑结膜入路去睑袋联合眶隔脂肪重置治疗泪沟畸形合并睑袋

Effect of blepharoconjunctival blepharoplasty combined with orbital fat transfer on lacrimal groove improvement in patients with lacrimal groove malformation

目的 观察睑结膜入路去睑袋手术联合眶隔脂肪重置治疗泪沟畸形合并睑袋的效果。方法 选取2019年11月至2021年11月期间我院收治的50例泪沟畸形患者为研究对象,依据患者的治疗方式将其分入观察组(25例,采用睑结膜入路去睑袋联合眶隔脂肪重置治疗)和对照组(25例,采用结膜入路下睑袋修复术治疗)。比较两组泪沟畸形改善效果、泪沟畸形等级评分(Tear trough rating scale,TTRS)、患者满意度及并发症发生情况。结果 观察组中有20例患者泪沟凹陷得到彻底改善,Barton分级包括13例Ⅰ级,7例Ⅱ级,有4例患者泪沟凹陷得到显著改善,Barton分级包括2例Ⅰ级,2例Ⅱ级,另外1例患者泪沟凹陷无显著改善,Barton分级为Ⅱ级;对照组中有13例患者泪沟凹陷得到彻底改善,Barton分级包括8例Ⅰ级,5例Ⅱ级,有6例患者泪沟凹陷得到显著改善,Barton分级包括2例Ⅰ级,4例Ⅱ级,另外6例患者泪沟凹陷无显著改善,Barton分级包括3例Ⅰ级,3例Ⅱ级,观察组泪沟凹陷改善效果方面显著优于对照组(P <0.05);两组手术前TTRS评分相比差异无统计学意义(P>0.05),手术后TTRS评分明显下降(P<0.05),且观察组降低幅度显著大于对照组(P<0.05);同时,观察组患者对本次泪沟畸形治疗满意度显著高于对照组(P<0.05);观察组脂肪肉芽肿、复视、下睑不平整等并发症发生率明显低于对照组(P<0.05)。结论 睑结膜入路去睑袋手术联合眶隔脂肪重置可显著矫正泪沟畸形。

Objective To analyze the effect of blepharoconjunctival blepharoplasty combined with orbital fat transfer on the improvement of lacrimal groove in patients with lacrimal groove deformity.Methods 50 patients with lacrimal groove malformation admitted to our hospital from November 2019 to November 2021 were selected as the study objects, and were divided into the observation group(25 patients, who were treated with blepharoconjunctival blepharoplasty combined with orbital fat transfer) and the control group(25 patients, who were treated with blepharoconjunctival blepharoconjunctival repair) according to the differences in treatment methods. The improvement effect of lacrimal groove deformity, Tear groove rating scale(TTRS), patient satisfaction and complications(including fat granuloma, diplopia and lower eyelid irregularity) were compared between the two groups.Results In the observation group, the lacrimal groove depression was completely improved in 20 patients, Barton’s classification included 13 cases of Grade Ⅰ, 7 cases of Grade Ⅱ, 4 cases of lacrimal groove depression were significantly improved, Barton’s classification included 2 cases of Grade Ⅰ, 2 cases of Grade Ⅱ, and 1 case of lacrimal groove depression was not significantly improved, Barton’s classification was Grade Ⅱ;In the control group, 13 patients had complete improvement of lacrimal groove depression. Barton’s classification included 8 cases of Grade Ⅰ and 5 cases of Grade Ⅱ. Six patients had significant improvement of lacrimal groove depression. Barton’s classification included 2 cases of Grade Ⅰ and 4 cases of Grade Ⅱ. The other 6 patients had no significant improvement of lacrimal groove depression. Barton’s classification included 3 cases of Grade Ⅰ and 3 cases of Grade Ⅱ. The improvement effect of lacrimal groove depression in the observation group was significantly better than that in the control group(P<0.05);There was no significant difference in TTRS score between the two groups before operation(P >0.05), but the TTRS score decreased significantly after operation(P <0.05), and the reduction in the observation group was significantly greater than that in the control group(P<0.05);At the same time, the satisfaction of patients in the observation group was significantly higher than that in the control group(P<0.05);The incidence of complications such as fat granuloma, diplopia and lower eyelid irregularity in the observation group was significantly lower than that in the control group(P <0.05).Conclusion Blepharoconjunctival blepharoplasty combined with orbital fat transfer has a very positive effect on the improvement of lacrimal sulcus in patients with lacrimal sulcus malformation, which is worth popularizing.