睑袋成形术并发泪囊功能不全  

Lacrimal sac insufficiency caused by lower lid blepharoplasty

作　　者：方芳[1] 张玮[1] 王林农[1] 

机构地区：[1]南京医科大学附属南京第一医院眼科,江苏南京210006

出　　处：《中国美容整形外科杂志》2006年第4期279-281,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨睑袋成形术导致泪囊功能不全的原因和治疗方法。方法对睑袋成形术后无睑外翻出现溢泪的患者,进行泪道功能检查,功能不全者行下睑睑部眼轮匝肌缩短或断端吻合,下睑眶部眼轮匝肌上移手术。结果28例患者因睑袋成形术后并发泪囊功能不全,再次手术时均发现有过量切除或未能缩紧(或缩紧不足)睑部眼轮匝肌。经手术加强睑部眼轮匝肌张力后,泪囊“泵”功能恢复,溢泪消失。结论睑袋成形术中,对多余及松弛组织去除量的控制不当,或术中未能有效地恢复下睑各层结构张力的平衡,尤其是下睑睑部眼轮匝肌张力明显减弱时,其泪囊的“泵”作用消失,出现功能性溢泪。通过手术恢复下睑轮匝肌张力的“泪泵”功能,有效地治疗了因睑袋成形术所并发的泪囊功能不全。Objective To study the causes and treatment of the lacrimal sac insufficiency after lower lid blepharoplasty. Methods The function of lacrimal drainage system in the patients who had epiphora without ectropion after lower lid blepharoplasty was checked. Lacrimal sac insufficiency was diagnosed in 28 patients （34 eyes）. The second surgeries were performed by shortening the pretarsal portion of the orbicu laris oculi muscle on lower lid or anastomosis it, shifting the orbital portion of the orbicularis oculi muscle of the identical lower lid to superior place. Results Excessive cuts or insufficient retractions of the pretarsal portion of the orbicularis oculi muscle was found in the second surgeries in all eyes. The pumping function of lacrimal sac recovered and the tearing disappeared after second surgery that strengthened the tension of the pretarsal portion of the orbicularis oculi muscle. Conclusion In lower lid blepharoplasty, it＇s important to control the quantity of the resection of the slack tissue and restore the tension of each layer. Especially in which the tension of the orbicularis oculi muscle on lower lid is very weak that the pumping functions of lacrimal sac will disappear and functional epiphora will occur.After the second surgery we performed, the pumping function of lacrimal sac was restored and lacrimal sac insufficiency complicated after blepharoplasty was successfully treated.

关 键 词：下睑成形术 睑部轮匝肌张力 泪囊功能不全 

分 类 号：R779.6[医药卫生—眼科]