改良经结膜入路眶隔脂肪释放移位固定行睑袋合并泪沟畸形整复的临床效果分析

Clinical Effect Analysis of Modified Transconjunctival Lower Eyelid Blepharoplasty Combination of Tear Trough Deformity Correction by Orbital Septum Fat Release and Graft Fixation

目的:探讨改良经结膜入路眶隔脂肪释放移位固定行睑袋合并泪沟畸形矫正的临床经验。方法:选取2018年1月-2021年11月扬州大学附属医院收治的下睑袋合并泪沟畸形就医者30例,其中男2例,女28例。年龄25~32岁,平均29岁。采用针式电刀经结膜入路打开眶隔,暴露眶隔内脂肪团;用蚊式血管钳钝性离断泪槽韧带,通过6-0双针缝线,分别缝合脂肪,出皮肤固定于泪沟区。结果:30例就医者手术均顺利完成,术后均一期愈合。下睑袋和泪沟得到明显改善,下眼睑外形恢复满意。结论:通过针式电刀切开结膜行睑袋合并泪沟畸形矫正,术中出血少,通过双针线两个针头同时从眶隔中缝挂脂肪经皮下穿出固定,能够大大节约手术时长,并且脂肪移位固定良好,提高手术效果,值得临床推广应用。

Objective To explore the clinical experience of modified transconjunctival lower eyelid blepharoplasty combination of tear trough deformity correction by orbital septum fat release and graft fixation.Methods A total of 30 patients with lower eyelid bag combined with tear trough deformity were selected from January 2018 to November 2021 in Affiliated Hospital of Yangzhou University,including 2 males and 28 females.The age ranged from 25 to 32 years,with an average age of 29 years.The orbital septum was opened and intraspinal cellulite was exposed by needle electric knife transconjunctival approach.The lacrimal groove ligament was bluntly severed with mosquito forceps,the fat was sutured with 6-0 double-needle suture,and the skin was fixed in the tear trough area.Results All 30 patients were successfully completed with primary healing after surgery.The lower eyelid pouch and tear trough were improved obviously,and the shape of lower eyelid was restored satisfactorily.Conclusion By using the needle electric knife,the intraoperative bleeding is less.By using two needles for hanging fat from the orbital septum through subcutaneous puncture and fixation,the operation time can be greatly saved,and fat displacement and fixation are good.The operation effect is improved,which is worthy of clinical application.