摘要
目的探讨上睑肌力调整矫正睑裂过小的手术方法及疗效。方法针对42例睑裂过窄的患者,采用切开法重睑成形术的常规切口,切开皮肤及皮下组织,如有上睑皮肤松弛切除适量松弛的皮肤,显露眼轮匝肌,如眼轮匝肌肥厚者去除睑板上缘以下的睑部眼轮匝肌。分离上睑提肌腱膜,剪开眶隔膜,暴露眶内脂肪,分离切除多余松弛下垂的眶内脂肪。嘱患者睁眼,观察睑裂大小,若睑裂增大,考虑患者是因眼轮匝肌肥厚或眶脂肪过多引起的眯缝眼。若睑裂仍小,可探查提上睑肌肌力是否正常。对伴有轻中度上睑下垂的患者同时做提上睑肌腱膜折叠缝合[5]。再用8-0美容线缝合切口下缘,带少许上睑板上缘组织,及切口上缘皮肤,观察其临床效果。结果 42例(84只眼)随访12个月,患者感觉视野开阔,眼裂增大,睁眼轻松,重睑线流畅,自然、双眼对称,眼部外观接近美学标准,无并发症,临床效果满意。结论上睑肌力调整矫正睑裂过小,是综合灵活针对不同的原因对因纠正眼部肌肉肌力不协调及眶隔脂肪过多或上睑皮肤松弛下垂的一种手术方法。手术效果佳,术后肿胀轻,恢复快,是值得临床推广的一种方法。
Objective To investigate the surgical method and efect of correction of blepharophimosis by adjusting the upper eyelid force. Methods A total of 42 patients with blepharophimosis, in which double-eyelid incision method was used to cut the skin and subcutaneous tissue. If the skin relaxes, we remove the loose skin, revealing the orbicularis oculi muscle. If there is hypertrophy of orbicularis oculi muscle, we remove the eyelid orbicularis oculi muscle below the upper eyelid. We then separate upper levator aponeurosis, cut the orbital septum, expose the orbital fat, and divide the sagging orbital fat in excess relaxation. The patients were asked to open the eyes , we observe the size of the palpebral fssure. If the palpebral fssure increases ,we consider patients’ squint eyes were caused by orbicularis oculi muscle hypertrophy or excess orbital fat. If the eye fssure is still not widely open, we should consider lifting the upper eyelid. Patients with mild to moderate ptosis were also treated with levator aponeurosis sutured. Then use the 8-0 beauty line to suture the lower edge of the incision, with a little tarsal upper edge of the organization and the upper edge of the skin, to observe the clinical results. Results 42 eyes （84 eyes） were followed up for 12 months： The patients felt that their visual felds were broadened, that eye fssure was enlarged, that they could open eyes easily, that the eyelid line was smooth, that the eyes were symmetrical, and that the appearance of the eyes was close to the aesthetic standard. Those patients were satisfed about the results because there wasn’t any kind of side efects. Conclusions Upper eyelid strength adjustment used to correct small palpebral fssure, is a comprehensive surgical method for diferent reasons due to muscle incoordination, too much orbital septum fat, or sagging upper eyelid skin. The surgical results are perfect; Postoperative swelling is light; Recovery is fast. In all, this method is worthy of clinical promotion.
出处
《中国医疗美容》
2017年第9期9-12,共4页
China Medical Cosmetology
关键词
睑裂过窄
眯缝眼
上睑下垂
Blepharophimosis
Squamous eyes
Ptosis
