下眼袋整复术并发症的防治

１９９２年１月至１９９４年１２月间行下眼袋整复术５６例，手术入路有二种：一种是经下眼睑缘皮肤入路；一种是经下眼睑结膜入路。经下睑缘皮肤入路（３６例），皮肤入路的切口由内侧睫毛缘开始，继向外侧方至第一个小的自然皱折处，距睫毛下宽度的范围，通常为２～３ｍｍ。经结膜入路（２０例），通过下眼睑的结膜小切口，抵达下眼袋。本组共发生并发症４例，将其分为二组，其中一组是暂时性，而另一组为持久或永久性。暂时性并发症通常为伤口肿胀、皮下瘀斑、睑变形等，上述并发症可以存在数日至几周，通常可以自行消退。发生下睑外翻２例，皮肤切除量不足２例，上述并发症可以持续数月或变为永久性，需采用保守治疗或外科手术进行积极处理。多数病人经３个月至１年随访疗效满意。作者认为正确选择手术进路和方法等，可以最大限度地减少并发症的发生。

Pervention and treatment of complications of surgery for baggy deformity of lower eyelids

The article introduces the prevention and treatment of complication of plastic operationfor baggy of lower eyelids, based on 56 cases treated from January 1992 to December 1994. Methods:Two approaches were used, one was transdermic approach of lower lids, and the othertransconjunctival approach. In the transdermic approach(36 cases).the incision was from the medialciliary margin to the first small natural crease laterally, usually 2 to 3 mm below the lash margin Thetransconjunctional approach(20 cases) was made through a small conjunctival incision on lowereyelids. The baggy of lower eyelids is easily reached. Results: The complications fell into two groups:temporary and persistant or permant Temporary complications were generally related to swelling ofwound,ecchymosis, lid distortion, and so forth. Such problems might persist for several days to severalweeks,then usually self corrected, ectropion of lower eyelid occured in 2 cases. and lower eyelid skinremoved inadegaately in 2 the cases. Results in most patients follow-up ranging from 3 months to 1year are satisfactory.Auther suggests that the appropriate selection of operative approach and methodsmay minimize complications.