经结膜入路直接内固定眶隔脂肪矫治泪沟型睑袋

Orbital septum fat repositioning with direct internal fixation via a transconjunctival approach for the correction of lower eyelid bags and tear trough deformity

目的观察采用经结膜入路直接内固定眶隔脂肪矫治无皮肤松弛的泪沟型睑袋的临床效果。方法回顾性分析自2016年6月至2021年6月,湖南省人民医院整形激光美容科对234例(468只眼)采用经结膜入路直接内固定眶隔脂肪方法矫治无皮肤松弛的泪沟型睑袋患者的临床资料。收集的数据包括年龄、手术时间、手术效果、患者满意度和术后并发症;根据Hirmand分类系统在手术前后评估泪沟的严重程度。结果234例患者平均年龄为(28.1±5.2)岁;平均手术时间为(50.0±8.3)min;平均随访时间为(10.5±3.8)个月。术前Hirmand分类Ⅰ型126只眼(26.9%)、Ⅱ型342只眼(73.1%);术后所有的Ⅰ型泪沟和324只眼Ⅱ型泪沟全部矫正,其余18只眼Ⅱ型泪沟改善为Ⅰ型。患者满意率为98.7%。未观察到严重的短期或长期并发症。结论经结膜入路直接内固定眶隔脂肪矫治无皮肤松弛的泪沟型睑袋安全、有效,值得临床推广应用。

Objective To observe the efficacy of orbital septum fat repositioning with direct internal fixation via a transconjunctival approach for the treatment of lower eyelid bags and tear trough deformity without skin laxity.Methods From June 2016 to June 2021,a retrospective study of 234 patients(468 eyes)who underwent orbital fat repositioning with direct internal fixation using a transconjunctival approach was performed.The collected data included age,duration of surgery,operation effect,patient satisfaction,and postoperative complications.The severity of tear trough deformity was assessed before and after surgery according to the Hirmand classification system.Results The mean age was(28.1±5.2)years.The mean operative time was(50.0±8.3)min.The mean follow-up time was(10.5±3.8)months.There were 126 eyes(26.9%)and 342 eyes(73.1%)with type I and type II tear trough deformity before surgery,respectively.After surgery,complete correction was achieved in all patients with type I tear trough deformity and 324 eyes with type II tear trough deformity.An improvement from preoperative type II to type I tear trough deformity was noted in the remaining 18 eyes.A total of 98.7%of patients were satisfied with their postoperative results.No serious short-term or long-term complications were observed.Conclusion Direct internal fixation of orbital septal fat repositioning via transconjunctival approach is safe and effective in the treatment of lacrimal trough eyelid bags without skin laxity,and it is worthy of clinical application.