眉下切口提眉术联合重睑成形术对中重度上睑皮肤松弛眼眶形态及美学评分的影响

Effects of Eyebrow Lifting Surgery Combined with Double Eyelid Plasty on Orbital Morphology and Aesthetic Score in Moderate to Severe Blepharochalasis

目的:探讨眉下切口提眉术联合重睑成形术对中重度上睑皮肤松弛眼眶形态及美学评分的影响。方法:选取2015年1月-2022年1月行手术治疗的中重度上睑皮肤松弛整形就医者214例为研究对象,随机选取107例就医者作为观察组(采用眉下切口提眉术联合重睑成形术治疗),54例就医者作为对照组1(采用眉下切口提眉术治疗),53例就医者作为对照组2(采用重睑成形术治疗)。术后,比较三组就医者眼眶形态改善效果[包括睑缘-角膜映光点距离(Marginal reflex distance 1,MRD1)、角膜内侧睑缘与重睑褶皱距离(Medial corneal margin-fold distance,MCMFD)、瞳孔中点睑缘与重睑褶皱距离(Middle pupil margin-fold distance,MPMFD)、外眦处睑缘与重睑褶皱距离(Lateral canthus marginfold distance,LCMFD)]以及皱纹改善效果和美学效果。结果:术后2个月,三组就医者眼眶形态改善情况存在显著差异(P<0.05),且观察组就医者MRD1、MCMFD、MPMFD、LCMFD均长于对照组1(P<0.05)和对照组2;术后三组就医者上睑皱纹较术前均有所改善(P<0.05),且随着时间增加皱纹评分显著降低(P<0.05),但三组间差异比较无统计学意义(P>0.05);术后3个月,三组手术效果美学评分存在显著差异(P<0.05),且观察组就医者自评及医师评分均高于对照组1、2,差异有统计学意义(P<0.05);术后三组并发症差异无统计学意义(P>0.05)。结论:眉下切口提眉术联合重睑成形术应用于中重度上睑皮肤松弛的治疗,能够显著改善就医者上睑皮肤松弛状态,减少上睑皱纹,调整眼眶形态,提高眉眼部美观效果。

Objective To explore the effects of eyebrow lifting surgery combined with double eyelid plasty on orbital morphology and aesthetic score in moderate to severe blepharochalasis.Methods A total of 214 patients with moderate to severe blepharochalasis were enrolled as the research objects between January 2015 and January 2022,including 107 cases in observation group(eyebrow lifting surgery combined with double eyelid plasty),54 cases in control 1 group(eyebrow lifting surgery)and 53 cases in control 2 group(double eyelid plasty).After surgery,improvement eff ect of orbital morphology[marginal refl ex distance 1(MRD1),medial corneal margin-fold distance(MCMFD),middle pupil margin-fold distance(MPMFD),lateral canthus margin-fold distance(LCMFD)]and wrinkles,and aesthetic eff ect in the three groups were compared.Results At 2 months after surgery,there were signifi cant diff erences in the improvement of orbital morphology among the three groups(P<0.05).MRD1,MCMFD,MPMFD and LCMFD in observation group were longer than those in control 1 group and control 2 group(P<0.05).After surgery,upper eyelid wrinkles in the three groups were all improved(P<0.05).The wrinkle scores were signifi cantly decreased with time in the three groups(P<0.05),but there was no signifi cant diff erence among the three groups(P>0.05).At 3 months after surgery,there were signifi cant diff erences in aesthetic scores of surgical eff ect among the three groups(P<0.05).The scores of patients'self-assessment and physicians in observation group were higher than those in control 1 group and control 2 group(P<0.05).There was no signifi cant diff erence in incidence of postoperative complications among the three groups(P>0.05).Conclusion The application of eyebrow lifting surgery combined with double eyelid plasty can signifi cantly improve blepharochalasis,reduce upper eyelid wrinkles,adjust orbital morphology and improve aesthetic eff ect of eyebrows and eyes in patients with moderate to severe blepharochalasis.