眼轮匝肌层间分离重睑成形术治疗青少年上睑倒睫的临床疗效

目的探讨眼轮匝肌层间分离重睑成形术治疗青少年上睑倒睫的临床疗效。方法采用3点式皮肤切开．做肌间及肌下双层面隧道式分离，去除预设重睑线下至睑缘上方1mm范围的深部眼轮匝肌及肌下组织，缝合固定浅层眼轮匝肌于上睑提肌腱膜。对上睑睫毛做3等份分区，分别测量睫毛的方位，即睫毛根部提升角（lift—upangle，LA）、睫毛体部卷曲角（bodycurl—upangle，BC）、睫毛末端卷曲角（endcurlupangle，EC），将将测量数据做定量分析。结果57例114只眼术后24个月时，I区睫毛LA由术前的（26．37±9．67）°提升到术后的（55．42±10．03）°（P〈0．01），11区睫毛LA由术前的（22．03±11．64）°提升到术后的（50．03±10．02）°（P〈0．01），Ⅲ区睫毛LA由术前的（25．31±8．01）°提升到术后的（64．05±8．33）°（P〈0．01），BC及EC在手术前后无明显变化（P〉0．01）。结论针对青少年上睑倒睫的患眼，采用眼轮匝肌层间分离重睑成形术的方法治疗，可获得较为美观的重睑形态和理想的消除倒睫的睫毛位置。

Clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis

Objective To evaluate the clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis. Methods Three cutaneous micro-incisions following intra- and sub-lamellar orbicularis dissections were performed and the deep orbieularis and suborbicularis fat pad between the intended eyelid crease and 1 mm above the eyelid margin were resected. The subcutaneous orbicularis was fixed to the exposed levator aponeurosis at the medial, center and lateral regions. For the quantitative analysis, the entire eyelid margins' eyelashes were equally divided into three sections and the eyelashes lift-up angle (LA), the body curl-up angle (BC) and the end curl-up angle (EC) were compared before and after surgery in each section, respectively. Results One hundred and fourteen eyes of 57 cases were followed up during 24-30 months. Compared to the LA before surgery and 2 years after surgery, it was changed from (26.37±9.67)° to (55.42± 10.03)° in section Ⅰ , and from (22.03±11.64)° to (50.03±10.02)° in section Ⅱ , and from (25.31±8.01)° to (64.05±8.33)° in section Ⅲ. There were no significant changes of BC and EC during following-up. Con-clusions For the adolescent upper eyelid trichiasis, the intra-lamellar orbicularis dissecting micro-trau-matic double eyelid surgery could acquire satisfactory aesthetic appearance and stable eyelashes'position at the same time.