改良Ⅰ期重睑成形联合内眦赘皮矫正术的疗效探讨

目的:探索一种设计简单、操作灵活、效果确实的Ⅰ期重睑成形联合内眦赘皮矫正术的新方法,以期达到自然、美观的眼部外形.方法:选取2011-09/2015-05采用Ⅰ期重睑成形术联合内眦赘皮开大术矫治单睑合并内眦赘皮患者62例124眼,包括对双上睑单睑常规行切开法重睑术,向内眦部延长重睑线切口,将内眦切口隐蔽在重睑线内;随后松解纵形内眦韧带,并重新定位理想的内眦形态,以减少内眦部皮肤张力;再根据新定位内眦形态适度去除多余皮肤组织,同时矫正双上睑单睑合并内眦赘皮外形.术后3mo~1a对患者进行随访,随访时间点分别为3、6mo,1a,在以上时间点对患者双上睑重睑的形态及内眦形态、内眦瘢痕等进行观察.结果:患者57例114眼获得3mo~1a的完整随访.通过对随访的57例114眼患者的重睑形态进行评估,永久性重睑、内眦赘皮矫正充分,形态满意者51例102眼,内眦赘皮部分矫正、形态改善者6例12眼,所有随访患者均未见内眦赘皮复发及严重瘢痕增生.结论:将内眦开大术与重睑成形术同期施行,内眦开大充分,切口隐蔽,可按实际皮肤量切除皮肤,术后切口瘢痕隐蔽,能够有效地解决内眦部皮肤的张力分布,获得永久性重睑和自然的内眦开大效果,是矫正单睑合并内眦赘皮的理想手术方法.

Effectiveness of a modified medial canthoplasty combined with upper eyelids blepharoplasty

AIM: To explore a simple, flexible and effective approach for medial canthoplasty combined with upper eyelids blepharoplasty aiming to achieve the natural and ideal appearance of eyelid.

METHODS: From September 2011 to May 2015, 62 cases(124 eyes)had received canthoplasty combined with upper eyelids blepharoplasty for single-folding eyelids and epicanthus were enrolled. Following the common upper eyelid blepharoplasty, an incision was prolonged to the medial canthus and was subsequently embedded within the double eyelid line. To decrease the skin tension, the canthal ligament was decompressed. Depending on the ideal appearance of the canthus, the upper eyelid and canthus were reformed next to the removal of excess skin. Patients were followed up for 3mo to 1a. At 3, 6mo and 1a, patients were investigated for the appearance of the canthus and the cicatrices.

RESULTS: Totally 57 cases(114 eyes)had 1 to 12 months'' follow-up. In these 57 cases, 51 patients satisfied with the permanent double eyelids and corrected epicanthus, 6 cases'' eyelids(12 eyes)appearance were improved partly. No recurrent epicanthus or hyperplastic scar was found in our study.

CONCLUSION: This approach combines medial canthoplasty with upper eyelids blepharoplasty to expose the canthus widely, hide the incision and scar, decrease the skin tension efficiently and remove the excess skin flexibly, which is an ideal method to correct epicanthus and single upper eyelids.