显微技术辅助皮下内固定法在重睑成形术中的应用

目的探讨显微技术辅助皮下内固定法（眼轮匝肌-提肌腱膜/睑板固定）在重睑成形术中的应用价值。 方法自2015年8月至2019年8月，采用显微技术辅助皮下内固定法行切开重睑成形术388例（男性21例，女性367例），其中伴轻度上睑下垂者76例。术后进行随访，评估伤口愈合情况及美学效果（重睑稳定性和重睑对称性）。 结果388例术后切口均一期愈合，无明显淤血、肿胀。160例获得随访3~24个月，平均随访9.6个月。大部分受术者重睑线弧度自然流畅，闭眼上睑皮肤平整，无明显凹陷、瘢痕及肉条现象，上睑下垂完全矫正。单侧重睑变浅3例，均二次手术修复。重睑不对称相对明显3例，其中2例再次手术修复。重睑线较窄4例。重睑稳定性评价：好97.5%（156/160），中1.9%（3/160），差0.6%（1/160）；重睑对称性评价：好96.3%（154/160），中2.5%（4/160），差1.2%（2/160）。 结论该方法可形成稳定的重睑皱襞，且避免了术后手术区域的凹陷、不平整及肉条现象，因其保留了较完整的眼轮匝肌，形成的重睑可呈现自然、动态的效果。

Microsurgical technique assisted subcutaneous fixation to create double eyelid

ObjectiveTo investigate the application of microsurgical technique assisted subcutaneous fixation (orbicularis oculi-levator aponeurosis/tarsus fixation) in double-eyelid operation. MethodsFrom August 2015 to August 2019, 21 male and 367 female patients (76 patients with ptosis) were selected to receive the treatment by microsurgical technique assisted subcutaneous fixation technique. Follow-up was performed to evaluate wound healing and aesthetic effects (double eyelid stability and symmetry). ResultsThe incisions of 388 patients healed well without obvious postoperative hematoma. One hundred and sixty patients were followed for 3-24 months (mean, 9.6 months) after operation. Most patients had smooth and natural upper eyelid crease. The skin tended to spread evenly without dimple or overly puff. The ptosis was also corrected. Still, there were three patients with shallower supratarsal folds on one side, and they underwent secondary repair. Three patients complained about asymmetry, and two patients underwent secondary repair. Four patients complained for too narrow crease. Double eyelid stability evaluation results were: good, 97.5% (156/160); fair, 1.9% (3/160); and poor, 0.6% (1/160). Double eyelid symmetry evaluation results were: good, 96.3% (154/160); fair, 2.5% (4/160); and poor, 1.2% (2/160). ConclusionThe microsurgical technique assisted subcutaneous fixation is a solid suture technique, and it can avoid sunken, depression, and puffiness. The created eyelid has a natural and dynamic appearance because of reserving the majority of orbicularis oculi muscle.