经下睑缘切口的睑袋整复术联合眶隔脂肪移植填充泪沟矫治下睑袋伴泪槽畸形

陈荣亮 张昕桐 孙榕呈 梁军

[摘要]目的：探討经下睑缘切口的睑袋整复术联合眶隔脂肪移植填充泪沟在下睑袋伴泪槽畸形患者中的应用效果。方法：对2017年12月-2019年1月在医院接受诊治的58例睑袋伴不同程度泪槽畸形患者采用经下睑缘切口的睑袋修复术+眶隔脂肪移植填充泪沟术，术后对患者进行随访，观察和评价手术效果。结果：58例患者均顺利完成手术，术后睑袋和泪槽沟凹陷改善满意，下睑形态自然，无下睑凹陷和眼睑退缩。随访1年，无患者睑袋复发，53例（91.38%）泪沟凹陷改善明显，效果良好，患者满意;另外5例患者（8.62%）泪槽沟改善效果不明显，行自体脂肪移植填充泪沟术后达到满意效果。结论：经下睑缘切口的睑袋整复术联合眶隔脂肪移植填充泪沟具有手术创伤小、操作易掌握和手术效果好等优点，可用于下睑袋伴泪槽畸形患者的修复治疗中。

[关键词]泪槽畸形;下睑袋;睑袋整复术;脂肪移植;疗效

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）07-0033-03

Application Effect of Blepharoplasty Through Lower Eyelid Margin Incision Combined with Orbital Septum Fat Transplantation in Patients with Lower Eyelid Pouch and Lacrimal Groove Deformity

CHEN Rong-liang，ZHANG Xin-tong，SUN Rong-cheng，LIANG Jun

（Department of Plastic Surgery，Meilai Medical Aesthetic Hospital，Chengdu 610000，Sichuan，China）

Abstract： Objective  To investigate the application effect of blepharoplasty through lower eyelid margin incision combined with orbital septum fat transplantation in patients with lower eyelid pouch and lacrimal groove deformity. Methods  From December 2017 to January 2019， 58 patients with different degrees of lacrimal groove deformity were treated with blepharoplasty through lower eyelid margin incision and orbital septal fat transplantation to fill lacrimal groove. After the operation， the patients were followed up to observe and evaluate the effect of the operation. Results  All the 58 patients successfully completed the operation， the improvement of pouch and lacrimal groove depression was satisfactory， the lower eyelid shape was natural， there was no lower eyelid depression and eyelid recession，and the skin relaxation in the middle of the face was improved. After one year follow-up， 53 cases（91.38%） had significant improvement in lacrimal groove depression， and the effect of annual orbital lightening was good， the patient was satisfied. The other 5 cases（8.62%） had no significant improvement in lacrimal groove， and the effect of filling lacrimal groove with autogenous fat transplantation was satisfactory. Conclusion  The blepharoplasty combined with orbital septum fat transplantation to fill lacrimal sulcus through lower eyelid margin incision has the advantages of small surgical trauma， easy operation and good operation effect， which can be used in the repair and treatment of patients with lower eyelid pouch and lacrimal groove deformity.

Key words：lacrimal groove deformity; lower eyelid pouch; blepharoplasty; fat transplantation; curative effect

面部老化早期主要表现为上睑皮肤松弛、眉下垂、“鱼尾纹”形成、外眦角下移及下睑皮肤、眶隔膜、眼轮匝肌松弛等[1]。眶脂肪移位脱垂会导致不同程度下睑组织下垂、膨隆和臃肿。此外，下睑部泪槽往往伴随睑袋存在，而且会呈现出加重趋势，严重影响面部美观[2]。作为最早出现的面部衰老表现，改善下睑部位衰老外观一直以来都是临床美容外科常见的修复内容，治疗方法较多，但绝大多数出现早期眶周老化问题的就医者会选择局部手术来达到改善下睑老化的目的[3]。……