眶隔紧缩修复在睑袋成形术中的意义

目的探讨眶隔紧缩修复在睑袋成形术中的意义。方法对157例40岁以下的就诊者，采用3种术式：（1）单纯脂肪摘除；（2）脂肪摘除＋眼轮匝肌悬吊；（3）眼轮匝肌悬吊＋眶隔紧缩修复。分析术后6个月至5年的随访结果，观察手术效果及复发情况。结果86例采用术式（3）者术后效果最好，均无复发；71例采用术式（1）或（2）者睑袋下半部在短期内有不同程度复发。结论40岁以下睑袋的成因是眼睑前壁薄弱松弛，睑袋出现术后复发者皆以前壁下半部为主，前壁下半部的加强叉以眶隔紧缩修复为最有效，眼轮匝肌悬吊的作用是加强前壁上半部及防止并发症发生。术式（3）手术后近远期效果均优于术式（1）和（2）。

Crimpling and repairing of orbital septum in plasty of lower eyelid bags

Objective To discuss the implications of orbital septum repairing and crimpling in the plastic surgery of lower eyelid bags. Methods The ultimate results were analyzed in the patients (aged less than 40) who received three different operations from six months to five years and the effect of operation and recrudescence of lower eyelid sag were observed. The procedures included simple fat removal, fat removal plus orbicularis oculi hanging, and orbicularis oculi hanging plus orbital septum repairing and crimplling. Results Since 2002, 157 cases were treated, and the ultimate effects of patients were analyzed. 86 cases treated with orbicularis oculi hanging plus orbital septum repairing and crimplling reached the best results without recurrence. 71 cases treated with simple fat removal or fat removal plus orbicularis oculi hanging experienced recurrence in different degree within a short period. Conclusion The weakness and laxation of the former wall causes the formation of lower eyelid bag, the appearance and recrudescence mainly locate below the former wall. Orbital septum repairing and crimpling most effectively strengthen the underside of the former wall. Orbicularis oculi hanging strengthens the top of the former wall and prevents any complications. The effects of the last procedure are better than that of the other two in the near future or in the long term.