横切纵缝法缩小内眦间距矫正假性内斜视  

Pseudoesotropia correction by shorten space of medial canthus with horizontal incisions and vertical suture

作　　者：陈文莉[1] 陈遐[1] 

机构地区：[1]天津市眼科医院医疗美容科,天津300020

出　　处：《中国美容医学》2012年第10期1728-1730,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:严重的内眦赘皮引起的假性内斜在18岁以后可以考虑美容治疗。本文探寻一种瘢痕隐蔽、简单易行、效果理想的手术方法,矫正假性内斜视面容,达到美容的目的。方法:采用内眦皮肤一字形横切口纵缝法缓解纵向紧张的皮肤张力,扇形修薄内眦增厚的皮下组织,离断祛除皮下错位、错构的眼轮匝肌,折叠缩短内眦韧带缝合固定于鼻侧腱膜,最大限度缩短内眦与鼻根部的距离,将皮肤与深部韧带缝合以增加皮肤矢量引力显露内眦窝。结果:接受手术48例,随访12周以上者44例,显效34例,占77.27%,有效8例,占18.18%,无效2例,占4.55%。术后12周内多数新内眦点会有少量回缩移位,内眦间距较术后即刻有不同程度增宽。经χ2检验术前内眦间距和睑裂宽度与术后12周的数据有显著性差异,两组均有统计学意义(P<0.01),内斜视外观改善明显,满意率95.45%。结论:一字形横切纵缝缩短内眦韧带的方法,有别于传统矫正方法的特点是先固定新内眦点,后根据需要修剪皮肤,避免了复杂的皮瓣转移和切口瘢痕。该方法适于矫正中、重度的内眦赘皮,缩小双眼内眦间距,内侧巩膜外露量增多,改变假性内斜"眼位异常"的容貌,是一种比较理想的手术方式,值得推广。Objective Pseudoesotropia caused by serious epicanthus can be treated by cosmetic surgery without correcting the position of eye.The author aims to offer a novel surgical approach has the merits of small wound, concealed scar,easy operation and optimal effects for correcting pseudoesotropia to obtain aesthetic appearance. Methods The author performed epicanthoplasties by using in-line horizontal incisions and vertical suture to lose the vertical tension of skin, relief subcutaneous tissue in sector area,cut malposition and hamartomatous orbicular muscle, fold and shorten medial canthal ligament and fastened to nasal aponeurosis to maximum shorten the space of medial canthus and nasion,suture skin and deep aponeurosis to reveal medial canthus nest by enhancing vector force. Results 48 patients accepted surgery, 44 cases followed up for 12 weeks. 34 cases （77.27%） produce effects, 8 cases （18.18%） produce valid, 2 cases （4.55%） produce invalid. Mostly the new point of medial canthus will has a little bit retraction and shift after 12 weeks. There were noticeable difference of the space of medial canthus and the width of palpebrarum rimae compared before and 12 weeks after surgery. There were significances in statistics by chi square test （P〈0.01）. 95.45% patients satisfied with the result. The appearance of esotropia were markedly improved. Conclusion The method is different from traditional way by locating new medial canthus point before skin removal, avoid skin flap transplantation and scar. Horizontal incisions and vertical suture is indicated for serious epicanthus by shortening the space of medial canthus and increasing the exposure of medial sclera.The operations improve the appearance of the patients,regain the confidence of them. It is an ideal surgery method and is worthy to be popularized.

关 键 词：横切纵缝法 假性内斜视 内眦赘皮 

分 类 号：R777.41[医药卫生—眼科]