改良眶隔法和传统睑板法切开重睑术的临床比较

Clinical Comparison of Double-Eyelid Blepharoplasty Using Orbital Septum and Tarsal

摘要: 目的：比较改良眶隔法和传统睑板法切开重睑术的术后重睑形态、瘢痕发生率及角膜暴露率，探讨改良眶隔法的临床效果。方法：选取青岛大学附属医院美容整形外科2019年7月至2020年1月50例单睑女性求美者(31例采用改良眶隔法，19例采用传统睑板法)。改良眶隔法要点如下：于眶隔中部打开眶隔，去除膨出的眶脂，眶隔下部向下反转后与切口下唇眼轮匝肌缝合固定，行间断缝合下唇皮肤–眶隔后壁筋膜–上唇皮肤，传统睑板法去除眶脂后直接行下唇皮肤–睑板–上唇皮肤缝合。结果：经6个月的随访，眶隔法切开重睑术术后重睑形态优于传统睑板法，切口瘢痕严重程度小于传统睑板法，两组角膜暴露率较术前均有所提升，两组角膜暴露率增加值未见明显差异。结论：改良眶隔法切开重睑术较传统睑板法切开重睑术外观更自然，术后瘢痕程度更轻，患者满意度更高。

Abstract: Objective: To explore the clinical efficacy of double-eyelid blepharoplasty with orbital septum and tarsal by comparing the postoperative double eyelid morphology, scarring and corneal exposure ratio. Methods: Fifty female patients in Affiliated Hospital of Qingdao University from July 2019 to January 2020 were analyzed on whom blepharoplasty was performed, 31 cases by “blepharoplasty with orbital septum” and other 19 cases by ‘‘blepharoplasty with tarsal’’. Blepharoplasty with orbital septum: We incised the orbital septum and turned downward the lower part of the dissected orbital septum and sutured to the lower orbicularis oculi muscle. After removed bulging orbital septum fat, we sutured skin with downward-turned orbital septum. Skin-orbital-skin suture was used in traditional method. Results: Six-month follow-up results revealed that the morphology of double eyelid after blepharoplasty with orbital septum was superior to that of the traditional surgery, and the severity of scar was less than that of the traditional surgery. The corneal exposure ratio of the two groups was improved compared with that before operation, but there was no significant difference in the corneal exposure ratio changing between the two groups. Conclusion: The blepharoplasty with orbital septum has a more natural appearance, less postoperative scar and higher patient satisfaction than the traditional blepharoplasty with tarsal.