经外眦部手术行睑裂开大术

目的：探讨睑裂短小经外眦部手术行睑裂开大术的方法。方法：经外眦隐裂横行切开皮肤长约5mm达外眦角，但不切开结膜囊，然后将切口延长到上下睑颞侧1／4处的上下睑缘的前后唇之间的灰线上，切开上下睑，使眼睑分为前后两部分。前部是皮肤和眼轮匝肌，后部是睑板和结膜，切口各长约5mm，完成了横向的“Y”形切口。电刀切断外眦隐裂皮肤切口下面的眼轮匝肌，使外眦处结膜囊游离。将外眦处游离的结膜囊缝合固定于外侧眶缘的骨膜上达到外眦韧带缩短的目的。术中根据睑裂开大的需求及可能，确定游离结膜的缝合点。可以开大睑裂3～5mm，仍然呈“Y”形缝合皮肤切口。结果：32例睑裂开大效果明显，睑裂延长，随诊3个月，没有出现组织回缩导致睑裂变短现象及结膜囊变浅，外眦无粘连，瘢痕不明显。结论：此方法为一种实用而有效的经外眦部手术行睑裂开大的手术方式。

Blepharodiastasis in outer canthus

Objective To explore the method of blepharodiastasis in outer canthus. Methods Designing transverse ＂Y＂ shape incision on the outer canthus and palpebral margin, Every the arm length of ＂Y＂ is 5 mm respectively. Transverse ＂Y＂ incision is cut at the outer canthus and palpebrat margin, but not cut conjunctival sac. The palpebral margin is divided into two parts. The front part is skin and orbicularis oculi muscle and the back part is the tarsus and conjunctiva. The orbicularis oculi muscle is cut off with Electric knife under the outer canthus skin incision. The conjunctival sac is sutured and fixed on the periorbit of the zygoma to achieve the objective that the lateral canthus ligament is shortened. According to the length of the requirements and the possibillity of blepharodiastasis, the point de suture of the conjunctival sac is determined. It can extend palpebral fissure 3 - 5 mm. Skin incision is sutured by ＂Y＂ shape. Results 32 cases of blepharodiastasis in out canthus, the effect of palpebral fissure extension is obvious.Follow-up for 3 months, local tissue do not turn up contracture, palpebral fissure do not become short and conjunctival sac do not become shallow as well. The outer canthus have not adhesion and local scar is not obvious. Conclusion This is a practical and effective method at blepharodiastasis in outer canthus.