眶隔脂肪游离移植在矫正泪槽畸形中的应用

Application of Orbital Septum Fat Free Transplantation in Correction of Lacrimal Groove Deformity

目的:探讨应用眶隔脂肪游离移植改善泪槽的临床效果,分析该方法的优点与局限性。方法:对2019年1月-2021年12月在哈尔滨医科大学附属二院应用眶隔脂肪游离移植治疗泪槽畸形的临床资料进行回顾性分析,共纳入41例就医者,年龄18~35岁,平均31.2岁。术前对就医者眶下区状态、泪槽畸形程度及就医者期望值进行评价,对于适合采取眶隔脂肪游离移植的就医者,通过医患共同决策的方法确定手术方式及手术细节。结膜入路微创下切取眶隔脂肪并形成脂肪微粒继而注射至标记好的泪槽区域眼轮匝肌下层,观察即刻手术效果。术后定期随访治疗效果及患者满意度。结果:术后随访半年以上。所有就医者无并发症发生,术后肿胀轻,局部消肿速度快,泪槽畸形改善明显。结论:眶隔脂肪游离移植是改善年轻泪槽畸形就医者的有效方法。该方法的局限性在于眶隔脂肪量体积不足,因此对于年龄较大或局部衰老明显就医者不适合此种方法。

Objective To explore the advantages and shortcoming of free orbital fat transplantation for improving tear trough.Methods The clinical data of patients who received free orbital fat transplantation in transconjunctival approach low blepharoplasty from January 2019 to October 2021 were analyzed retrospectively.41 patients whose age were from 18 to 35 and average age was 31.2.The condition of low blepharo area,tear trough and requirement of patients were analyzed and filtered out the patients who were fitted for free orbital fat transplantation.Then,according to principles of shared decision making,plastic surgeron and patients discussed and exchanged views about the details and style of operation.The orbital fat was cut through transconjectival approach and then injected them into the area of tear trough.Surgeron and patients observed the form until the patient were satisfied with the morphology of tear trough area.Results Surgerons completed the operation for every patient.All the patients were followed beyond half a year and they were satisfied with the surgical results.No complication happened among all the patients.Conclusion Free orbital fat transplantation for improving tear trough was the suitable choice in many surgical treatments.However,due to no enough of orbital fat volume,it wasn’t fit for patients whose age was old or whose tear trough was severe.