摘要目的 探讨双重固定联合眼轮匝肌后脂肪部分切除在重睑成形术中的临床应用.方法 对152例均存在上睑肥厚、臃肿者,行重睑成形术,于切口下唇切除部分增厚的睑板前纤维脂肪组织;切口上唇去除部分眼轮匝肌后的眶隔前以及眶上缘外侧骨膜前脂肪组织,适度去除部分肥厚的眶隔脂肪.采用双重固定形成稳定持久的生理性动态重睑皱褶:真皮-眼轮匝肌-睑板(或上睑提肌腱膜),皮肤-眶隔膜(或上睑提肌腱膜)-皮肤,术后随访3～24个月.结果 全部受术者上睑臃肿情况有所改善,1例出现术后早期上睑局部小血肿,10d后自行吸收缓解;2例术后重睑皱褶变浅,行再次手术修复;3例眉外侧上方区域术后出现局部麻木,3个月后自行缓解恢复.其余146例受术者睁闭眼时上睑形态自然,切口瘢痕不明显,效果满意.结论 针对上睑较为臃肿的单睑者行重睑手术,采用双重固定联合眼轮匝肌后脂肪部分切除,可以在改善上睑臃肿的同时,形成较为稳定持久的动态重睑.

abstractsObjective To summarize the experience of clinical application of combining double suture fixation and resection of partial fat retro-orbicularis oculus in some specially difficult blepharoplasty.Methods During upper blepharoplasty,patients with heaviness and bulkiness in the both upper eyelid and lateral upper orbital region,we combined double suture fixation and resection partial fat retro-orbicularis oculus.First,partial pretarsal bulky fat was resected,and to form skin-orbicularisoculi composite below incision line.And then,some thickened fat retro-orbicularis oculus was resected,which was also named preseptal and retro-orbicularis oculus fat (ROOF).Double suture fixation techniques were applied to form dynamic and physiological double eyelid.Results 146 cases had satisfactory effectiveness,except for 2 cases with secondary operation because of some superficial double eyelid creases,and 1 case had hematoma,and 3 had transient numbness in the lateral supraorbital nerve region.They were satisfied with healthy eyelid skins,concealed incision and non-serious complications followed at 3-24 months postoperatively.Conclusions Combining double suture fixation and resection of partial fat retro-orbicularis oculus would appear to be a useful adjunct to standard blepharoplasty techniques in selected patients.