切开入路眼轮匝肌-睑板固定法重睑成形术的效果  

Clinical effects of pretarsal orbicularis-tarsus fixation technique in double eyelidplasty

作　　者：孙维绎 尹宁北 宋涛 吴镝 李海东 王永前 Sun Weiyi;Yin Ningbei;Song Tao;Wu Di;Li Haidong;Wang Yongqian(Plastic Surgery Hospital,Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院整形一科,北京100144

出　　处：《中华医学美学美容杂志》2021年第4期285-288,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：北京协和医学院教学改革项目(10023201900401)。

摘　　要：目的探讨眼轮匝肌-睑板固定法切开重睑成形术的效果。方法2015年1月至2018年12月,中国医学科学院整形外科医院对要求行重睑成形术或重睑术后修复的美容就医者798例(男23例,女775例,年龄16~55岁,平均29岁),用切开入路眼轮匝肌-睑板固定法进行手术。术中适量去除皮肤、眼轮匝肌、眶隔脂肪后暴露睑板上缘,通过双侧对称眼轮匝肌-睑板固定实现重睑成形,切口闭合用皮肤-皮下组织-睑板前筋膜的间断缝合,预防瘢痕粘连。结果798例美容就医者手术均一期愈合,术后随访2~46个月,所有切口愈合良好,未出现重睑消失、线结外露、瘢痕增生或凹陷等问题。通过术后自评,766例(95.99%)美容就医者对手术效果满意。22例双侧重睑形态不对称及10例近内眦处重睑形成不良者进行了局部调整,修复效果良好。结论睑板前眼轮匝肌-睑板固定法重睑成形术操作简易,术后并发症轻微,可获得良好、稳定的重睑形态。Objective To evaluate the aesthetic outcome of the pretarsal orbicularis-tarsus fixation technique in incisional double eyelid blepharoplasty.Methods Postoperative results were evaluated from 798 patients who underwent the orbicularis-tarsus fixation blepharoplasty from January 2015 to December 2018.Based on an incisional maneuver,soft tissue was carefully removed to expose the superior edge of tarsus,then the pretarsal orbicularis oculi muscle was anchored on the tarsus.For skin closure,both skin margins,a small bite of subcutaneous tissue and the pretarsal fascia were interruptedly sutured to enhance cicatricial adhesion.Results All patients successfully underwent double eyelidplasty using this modified technique.The follow-up period ranged from two to forty-six months,with a mean period of twenty months.Ninety-six percent of the patients were satisfied with postoperative outcomes.Twenty-two cases of palpebral fold asymmetry and ten cases of unsatisfactory fold formation near the inner canthus were encountered.However,all the defects had been well improved by minor revisions.No supratarsal crease drooping or disappearing,suture spitting out,scar hypertrophy or crease depression were observed postoperatively.Conclusions The orbicularis-tarsus fixation method is a reliable technique for double eyelid plasty.It enables high feasibility and long-lasting result,with lower risk of postoperative complications.

关 键 词：眼睑成形术 眼轮匝肌-睑板固定 手术改良 

分 类 号：R779.6[医药卫生—眼科]