Functional outcomes of upper eyelid blepharoplasty: A systematic review

Objective

Various functional outcomes after upper blepharoplasty are reported in the literature. We systematically reviewed the literature to assess the objective and subjective functional effects of upper blepharoplasty.

眼睑畸形或缺损的修复与再造

文章报告了２４４例眼睑缺损或畸形病例的手术治疗方法及效果评价。烧伤后眼睑皮肤缺损的修复应尽早进行，以预防睑外翻及其它畸形的发生。下眼睑全层缺损可应用颊部旋转推进皮瓣或Ｔｅｎｚｅｌ皮瓣。睑板缺损以鼻隔软骨植入再造为好。自正常眼睑切取眼睑复合组织，带蒂或游离移植修复眼睑缺损宜慎重。眦角成形一般应留待上、下睑畸形矫正或缺损修复之后进行     

异体巩膜移植替代睑板重建眼睑

目的 探讨异体巩膜移植替代睑板重建眼睑的临床效果。方法 1986年5月～2001年1月对45例部分眼睑缺损患者，采用异体巩膜替代睑板行眼睑重建。其中男31例，女14例，上睑18例，下睑27例；累及上或下眼睑内眦都9例，外眦都7例，眼外伤22例，眼睑肿瘤23例。眼睑缺损不超过眼睑总长度的1／2。术后观察重建眼睑的外观、功能及并发症。结果 45例移植异体巩膜行眼睑重建均获成功。术后随访11～38个月，平均19．7个月。重建的眼睑完整，双侧眼睑长度及高度差值均小于2mm。眼睑开闭及上提功能基本正常，对视功能无影响。结论 异体巩膜是替代睑板行眼睑重建的理想材料。     

Treatment of extrinsic ectropion on burned face with facial suspension technique

The extrinsic ectropion is a condition with low prevalence characterized by an ectropion with normal eyelid and anatomy unchanged and the cause is found in tissues adjacent orbits. There are not many studies in the literature regarding their treatment, especially without addressing the eyelid respecting its anatomical integrity.PurposeTo evaluate the outcome of 8 extrinsic ectropions secondary to facial burns treated with facial suspension technique.Patients and methodsFive patients were evaluated with sequelae of facial burns and extrinsic unilateral or bilateral ectropion, a total of 8 ectropions. The technique used was the endoscopic facial suspension with or without release of the facial scar retraction. We evaluated the position of the lower lid over medium-pupillary line, symptoms, complications and patient satisfaction in a 24 months follow-up.Results6 Peri-orbital regions showed good results and two moderate results, all cases had clinical improvement of the ectropion, the symptoms and the esthetic aspect; there was not any complication or reoperation. There was a gain of 2.2–26.2% of the lower eyelid margin position in relation to the horizontal mid-pupillary line.ConclusionThe endoscopic facial suspension proved to be a surgical technique with low morbidity and efficient treatment in 8 facial extrinsic ectropion.     

Periorbital Rejuvenation Combining Fat Grafting and Blepharoplasties

Most surgical techniques intended to rejuvenate the midface do not address the palpebro-malar junction. With the advent of lipostructure, it appeared possible to perform at the same time surgery of the upper and lower eyelid and fat grafting. The technical method and instruments are described. The results are more natural than with a standard blepharoplasty because fat grafting restores a more youthful three-dimensional appearance.     

Microvascular Surgery

Methods of anastomosing small blood vessels are presented, together with an account of the authors' own experiences in the field of microvascular surgery. Practical suggestions are made to avoid pitfalls. The modern literature on experimental and clinical applications of microvascular technique in plastic and reconstructive surgery is reviewed. An extensive bibliography is offered as an aid to the interested reader.     

整体护理措施在眼部整形手术患者中的应用效果

目的 观察对眼部整形手术患者予以整体护理措施的效果。方法 选择2022年5月-2023年4月 于联勤保障部队第988医院眼科行眼部整形手术的86例患者为研究对象，随机分为对照组和研究组，每 组43例。对照组予以常规护措施，研究组予以整体护理措施，比较两组并发症发生情况、治疗时间、 眼部功能、眼睑形态、美容效果评分及护理满意度。结果 研究组并发症发生率为6.98%，低于对照组的 25.58%（P＜0.05）；研究组红肿消退、拆线时间均短于对照组（P ＜0.05）；研究组眼部功能、眼睑形态、 美容效果评分均高于对照组（P＜0.05）；研究组护理满意度为97.67%，高于对照组的76.74%（P＜0.05）。 结论 对眼部整形术患者予以整体护理措施的效果良好，可减少并发症，缩短治疗时间，促进术后快速恢 复，有利于提升护理满意度。     

Treatment of congenital and acquired upper eyelid ptosis: report of 131 consecutive cases

In this paper, a 5-year experience in the management and surgical treatment of upper eyelid ptosis at the Plastic Surgery Institute of Milan University Medical School is presented. From September 1992 to April 1996 a total of 131 consecutive cases were treated surgically. The patients are grouped into three categories: those with good residual function of the levator muscle in which a levator resection procedure was performed; those with poor residual function in which a frontalis suspension was selected; and those with moderate residual function in which levator surgery was the initial treatment, followed by a second operation (frontalis suspension) in unsatisfactory results. At postoperative follow-up, 101 cases were rated good, 22 were fair, and nine were poor. Early and late complications are discussed, together with some important key-points in the management and surgical treatment of the patients. Received: 31 December 1999 / Accepted: 6 May 2000     

眼睑恶性肿瘤切除术后自体硬腭黏膜移植眼睑再造

目的 眼睑恶性肿瘤切除术后采用自体硬腭黏膜替代眼睑后层进行眼睑再造，并对其临床效果进行评价。方法1998年1月～2003年10月，对18例（18眼睑）患者行眼睑恶性肿瘤切除术后，局部旋转移位皮瓣或游离皮瓣联合自体硬腭黏膜替代眼睑后层的眼睑再造术。其中男10例，女8例，年龄35～67岁。18例均为重度眼睑缺损，其中眼睑全部缺损12例，2／3眼睑缺损6例。眼睑基底细胞癌10例，睑板腺癌6例，眼睑鳞状细胞癌2例。结果18眼睑术后外观及功能基本恢复正常，闭合完全，无内外翻。术后随访6个月～4年，平均3年2个月，眼睑形态及功能保持稳定，无植片感染及挛缩，无免疫排斥反应，无肿瘤复发。结论自体硬腭黏膜代替眼睑后层作眼睑恶性肿瘤切除术后的眼睑重建术，是一种简便易行、取材方便、术后并发症少、临床效果满意的眼睑再造术，硬腭黏膜优于传统的眼睑后层替代材料。     

Periocular skin reshaping by CO2 laser coagulation

When blepharoplasty is performed by transconjunctival route, sometimes the excess of skin created by overlaxness of the lower lid does not retract to achieve the desired cosmetic result. We propose a method for controlled retraction of the eyelid by coagulating the skin using the CO₂ laser. Thanks to this approach, the lower eyelid's tone recovers and the desired cosmetic appearance is achieved. Results of 37 patients that were treated by 10 W CO₂ laser, 5-mm defocused beam diameter, and pulses of 100 ms, are presented. Follow-up shows that periocular skin reshaping by CO₂ laser for laxened eyelid is a safe method and it can be considered a good alternative of treatment for blepharochalasis without skin excision.     

小切口去脂肪联合连续埋线法治疗上睑重睑不对称的临床效果

探究小切口去脂肪联合连续埋线法治疗上睑重睑不对称的临床效果。方法 选取宜昌市前卫 整形美容门诊部2021年10月-2023年1月收治的68例上睑重睑不对称患者为研究对象，采用随机数字表法 分为对照组和观察组，各34例。对照组采用传统切开重睑术治疗，观察组采用小切口去脂肪联合连续埋 线法治疗，比较两组临床疗效、围术期相关指标、治疗满意度、心理状况及并发症发生情况。结果 观察 组治疗优良率为97.06%，高于对照组的73.53%，差异有统计学意义（P ＜0.05）；观察组手术操作时间、 术后愈合时间短于对照组，术中出血量少于对照组，差异有统计学意义（P ＜0.05）；观察组治疗满意度 为97.06%，高于对照组的70.59%，差异有统计学意义（P ＜0.05）；观察组SCL-90评分低于对照组，差异 有统计学意义（P ＜0.05）；观察组术后并发症发生率为5.88%，低于对照组的29.41%，差异有统计学意义 （P ＜0.05）。结论 上睑重睑不对称整形中采用小切口去脂肪联合连续埋线法安全性及可行性处于较高水 平，可缩短手术时间，减少术中出血量，促进术后切口愈合，且患者治疗满意度及生活质量较高。     

150例眼睑缺损的手术修复

目的 探讨各种原因致不同程度眼睑缺损、畸形修复的有效方法.方法 收集自2010年2月至2013年2月,因各种原因所致不同程度眼睑缺损的患者150例150眼,对其临床资料进行回顾性分析.对眼睑缺损范围＜睑裂长度1/4者72只眼,＞1/4或＜1/2者57只眼,＞1/2者21只眼,分别采用直接拉拢缝合法,联合滑行、转位、游离皮瓣修复眼睑缺损.结果 术后随访1～24个月,1例因恶性肿瘤复发而再行肿瘤切除术后,发生下睑退缩致闭合不全,其余149例均获Ⅰ期愈合,眼睑局部皮瓣全部成活,眼睑形态良好,睑缘位置正常,眼睑功能正常.结论 对各种原因所致眼睑缺损、畸形的患者,采用不同眼睑重建方法,灵活应用异体巩膜、结膜、黏膜等生物材料及各种皮瓣转移法修复缺损创面,可有效恢复眼睑的结构和形态,值得临床推广应用.     

应用局部皮瓣修复上睑全层缺损一例报告

目的探讨局部皮瓣修复上睑全层缺损的价值。方法2007年3月,对一例狗咬伤所致的右侧上睑全层缺损进行急诊局部皮瓣修复手术。结果术后随访45d,右侧上睑外形满意,功能良好。结论应用局部皮瓣急诊修复眼睑全层缺损,术后效果满意,可避免Ⅱ期手术和睑缘缝合。     

耳后岛状皮瓣修复眼睑外翻畸形

采用耳后岛状皮瓣法修复眼睑外翻畸形３例，获得较好的效果。讨论了该手术方法的优缺点，手术适应证以及手术注意要点。