内眦赘皮矫正联合外眦成形术在睑裂短小患者中的应用

三联术治疗小眼球小睑裂畸形（武汉大学中南医院眼科 430071）【摘要】目的: 探讨小眼球小睑裂畸形的手术整形方法。

方法: 对14例小眼球小睑裂畸形患者采用外眦开大成形、medpor义眼台植入、结膜囊成形三联手术，一次手术成形。

结果: 随访一年，睑裂宽度增加5mm，结膜囊宽敞，义眼配戴满意，术后外观明显改善。

结论: 对小睑裂畸形的患者运用三联术，术式简单，整形效果满意。

【关键词】小眼球;小睑裂;整形；medportreatment for the malformations of small eyeball and small palpebral fissureluo hong dai hanjun【abstract】objectiveto investigate the operation reshaping strategy of of themalformations of small eyeball and small palpebral fissure.method 14 eyes（14 cases） of malformation who accepted the surgical treatment including the porous polyethylene （pp）orbital implant（medpor） after evisceration, outer canthal expanding,and conjunctival sac forming were retrospective analyzed.resultfollow up for one year，the width of schizoblepharia augmented 5mm，conjunctival sac commodious, artificial eye satisfactorily matched,the appearance ameliorated evidently post-operation.conclusion trigeminy operation utilized on small eyeball and small palpebral fissure patients,the operation strategy is simple and received satifactory reshaping effect.【key words】small eyeball;small palpebralfissure ;plastic operation ; medpor【中图分类号】r779.64【文献标识码】a【文章编号】1008-6455（2011）06-0269-02先天性小眼球和无眼球是一类以眼球前后径小于正常范围或眶内眼织完全缺失为特征的先天性发育异常性眼科疾病，常伴有其他眼部变，50%的小眼球和无眼球合并其他全身性异常［1］。

·美容外科·《中国医疗美容》第8卷 第2期（总第54期）2018年2月横切法内眦赘皮矫正术联合重睑成形术刘亚非1，刘东篱2 ，赵 丽1，周 云1，李 韵1（1.江津区中心医院医学整形美容科，重庆 江津，402260 ；2. 江津中学，重庆 江津，402260）【摘 要】 目的探讨横切法内眦赘皮矫正术联合重睑成形术的效果及可行性。

方法50例采用横切法行内眦赘皮矫正术联合重睑成形术的患者为研究对象，术前设计好内眦部的切口，术中在内眦部皮下松解增厚的皮下组织及错构的上下睑眼轮匝肌，切断浅层内眦韧带，缩短重建内眦韧带，切除上下睑皮肤多余的“猫耳”。

再根据患者眼睑具体情况行全切开法重睑术或者三点式重睑术。

结果随访6月至18月，50例患者均内眦赘皮得到完全矫正，内眦无瘢痕形成，重睑形态自然，弧度良好。

结论横切法内眦赘皮矫正术联合重睑成形术操作简单，手术时间短，术后内眦部无瘢痕形成，重睑形态良好，更适合“三庭五眼”的比例，适合在临床推广。

【关键词】横切法；内眦赘皮；重睑DOI:10.19593/j.issn.2095-0721.2018.02.003The correction of epicanthus in transvers incision combined with double eyelid plastyLIU Ya-fei1, LIU Dong- li2, ZHAO Li1, ZHOU Yun1, LI Yun1(1.Plastic and Reconstructive Surgery , Jiangjin District Central Hospital, Chongqing City, 402260, China;2.Jiangjin middle school, Chongqing City, 402260, China )[ABSTRACT] Objective To investigate the feasibility and effect of crosscutting for epicanthoplasty combined with double eyelid plasty. Methods 50 cases with crosscutting method for correction of epicanthus with double eyelid plasty patients as the research object, preoperative design of inner canthus incision, intraoperative canthus subcutaneous loose subcutaneous tissue and thickening of the hamartoma solution of lower eyelid orbicularis muscle, cut off the superficial layer of the medial canthal ligament, shrinkage short reconstruction of medial canthal ligament resection on the lower eyelid skin, extra "cat ears". According to the specific circumstances of the whole eyelid incision blepharoplasty or three point double eyelid surgery. Results The follow-up of 6-18 months , 50 cases of patients with epicanthus was completely corrected, canthus without scar formation, double eyelid is natural, good radian. Conclusion Crosscutting method for epicanthoplasty combined with double eyelid plasty has the advantages of simple operation, short operation time, postoperative inner canthus without scar formation, double eyelid is good, more suitable for the"five eyes and three court "proportion, suitable for clinical application.[KEY WORDS] corsscutting method; epicanthus; double eyelid内眦赘皮是指在内眦角前方有呈蹼状皮肤皱褶，又称内眦皱襞，常见于亚洲人，常伴有单睑。

改良Y—V成形内眦赘皮矫治术联合切开法重睑术的临床应用作者：李娜李广帅刘林嶓等来源：《中国美容医学》2014年第01期[摘要]目的：探讨改良Y-V成形内眦赘皮矫治同期行切开法重睑成形术在临床中的应用效果。

方法：以2011年12月～2013年7月共136例内眦赘皮并单睑病例为研究对象，根据典型Y-V成形原理，对Y的长臂及两短臂的形态、位置及短臂与长臂的夹角进行改良，个性化设计成形切口线，并同期行切开法重睑术。

结果：采用改良Y-V成形内眦赘皮矫治术联合切开法重睑术，术后内眦部位切口隐蔽，无明显瘢痕，重睑皱襞弧度流畅自然，与内眦部延续自然，符合美学标准。

随访3～15个月，手术效果稳定，无复发。

结论：改良Y-V成形内眦赘皮矫治同期行切开重睑成形术，是矫治单睑伴内眦赘皮的一种操作简单、实用的方法，值得在临床推广应用。

[关键词]内眦赘皮；改良Y-V成形内眦赘皮矫治术；重睑成形术[中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2014）01-0001-04内眦赘皮为内眦皮肤前方自上而下呈顺向性或自下而上呈反向行的蹼状皮肤皱褶，呈半月型，常可遮住部分泪阜及半月皱襞，重者可遮挡部分视线，使睑裂变短，内眦间距增宽，影响眼睑美观，是黄种人常见的眼睑特征之一，又称蒙古皱襞，发生率约50%，单睑人种中发生率为70%[1]，目前常用的内眦赘皮矫治手术方式有横切纵缝术、Z成形术、W成形术及Y-V术等。

自2011年12月～2013年7月，笔者根据Y-V成形原理，应用改良Y-V成形内眦赘皮矫治术联合同期切开法重睑成形术，共完成手术136例，术后随访3～15个月，临床效果满意。

1 资料和方法1.1 临床资料：本组136例，其中男5例，女131例，年龄18岁～42岁，平均29岁。

均为双侧先天性内眦赘皮合并单睑者。

内眦赘皮程度：轻度26例，中度95例，重度15例。

全部行改良Y-V成形内眦赘皮矫治联合同期切开法重睑成形术，术前告知患者停止服用影响凝血功能药物2周以上，女性患者应避开月经期、妊娠期及哺乳期[2]。

Z成形术联合内眦部眼轮匝肌切除矫正内眦赘皮的临床应用研究张朋;刘海;孙余飞【摘要】目的:探讨Z成形术联合内眦部眼轮匝肌切除矫正内眦赘皮的临床疗效.方法:选取笔者科室2014年1月-2016年6月收治的内眦赘皮60例,并分为观察组和对照组,每组各30例.对照组患者行Z形术矫正内眦赘皮;观察组采用Z成形术联合内眦部眼轮匝肌切除矫正内眦赘皮,两组患者均同期行切开法重睑术.比较两组术前和术后患者睑裂长度(HLFL)、内眦间距(ICD),以及睑裂长度和内眦间距比值(HLFL/ICD).结果:对照组术后睑裂长度和内眦间距比值(HLFL/ICD)为0.87±0.04,较术前睑裂长度和内眦间距比值(HLFL/ICD)有所改善(P<0.05);观察组术后睑裂长度和内眦间距比值(HLFL/ICD)为0.90±0.06,较术前睑裂长度和内眦间距比值(HLFL/ICD)有所改善(P<0.05);术后观察组HLFL/ICD的平均比值大于对照组术前及术后的HLFL/ICD平均比值,差异具有统计学意义(P<0.05).随访6个月,对照组有1例患者出现内眦赘皮复发,观察组所有患者均无感染、瘢痕增生及内眦赘皮复发情况的发生.结论:Z成形术联合内眦部眼轮匝肌切除矫正内眦赘皮,能够有效矫正内眦赘皮,达到重睑美学效果,同时避免内眦赘皮复发,瘢痕增生,值得临床推广应用.%Objective To investigate the clinical effect of Z plasty combined with orbicularis oculi muscle resection and correction of the inner canthus. Methods From January 2014 to June 2016 in our hospital were treated 60 cases of patients with internal fixation, and divided into observation group, each group of each group of 30 cases. The control group underwent Z surgery for correction of epicanthus, the observation group was treated with Z plasty combined with canthal orbicularis muscle resection andcorrection of epicanthus, two patients underwent double eyelid operation. The ratio of palpebral fissure length(HLFL), medial canthus distance (ICD), and the ratio of palpebral fissure length to inner canthus distance(HLFL/ ICD) were compared between the two groups before and after surgery. Results In the control group, postoperative palpebral fissure length and inner canthal distance ratio (HLFL/ICD) was 0.87±0.04, compared with the preoperative palpebral fissure length and inner canthal distanceratio(HLFL/ICD) improved(P<0.05). The patients in the observation group after the palpebral fissure length and inner canthal distance ratio(HLFL/ICD) was 0.90± 0.06, compared with the preoperative palpebral fissure length and inner canthal distance ratio(HLFL/ICD) improved(P<0.05). Postoperative observation group average ratio of HLFL/ICD average ratiois greater than that of the control group before and after surgery, the difference was statistically significant (P<0.05). Followed up for 6 months, the control group, there were 1 cases of recurrence of the disease, all patients in the observation group were no infection, scar hyperplasia and recurrence of the recurrence of the disease. Conclusion Z plasty combined with canthal orbicularis muscle resection and correction of epicanthus, can effectively correct the epicanthus, achieve aesthetic effect and avoid the recurrence of the double eyelid, epicanthus, scar hyperplasia, worthy of clinical application.【期刊名称】《中国美容医学》【年(卷),期】2017(026)005【总页数】3页(P82-84)【关键词】Z成形术;内眦赘皮;内眦赘皮矫正术;重睑术【作者】张朋;刘海;孙余飞【作者单位】上海华美医疗美容医院上海 200000;上海华美医疗美容医院上海200000;上海华美医疗美容医院上海 200000【正文语种】中文【中图分类】R622内眦赘皮是临床上常见的眼部畸形，主要表现为内眦间距大和睑裂长度缩短［1-2］，因此内眦赘皮的存在往往对重睑的外形带来一定影响。

内眦赘皮应用切开重睑成形术联合Park-Z成形术效果观察时璐娜【摘要】目的观察内眦赘皮应用切开重睑成形术联合Park-Z成形术的效果.方法2016-01-2018-02间,濮阳市油田总医院对60例内眦赘皮者应用切开重睑成形术联合Park-Z成形术.回顾性分析受术者的临床资料.结果本组手术过程顺利,术后随访6～12个月,其间8例出现内眦部轻度瘢痕增生,予以皮下注射得宝松后瘢痕增生改善明显.内眦赘皮消失、泪阜显露良好、内眦间距缩短、重睑形态自然且效果满意者44例,感宽度轻微不对称、效果尚可16例.随访期间无内眦赘皮复发.结论应用切开重睑成形术联合Park-Z成形术矫正内眦赘皮,术后内眦处瘢痕不明显,重睑弧度自然,美容效果满意.【期刊名称】《河南外科学杂志》【年(卷),期】2019(025)002【总页数】2页(P138-139)【关键词】重睑术;Park-Z成形术;内眦赘皮【作者】时璐娜【作者单位】河南濮阳市油田总医院烧伤整形科濮阳457001【正文语种】中文【中图分类】R777.1内眦赘皮的典型特征为内眦角被遮盖而呈蹼状，又称蒙古皱劈，可分为先天性和后天性。

先天性最为常见，可分为眉形、睑形、睑板形、下睑形以及混合形等。

而后天性常由外伤导致。

重睑术属于美容或整形外科一种较为常见的手术方法，对单睑或内双重睑合并内眦赘皮者仅采用切开重睑成形术无法有效处理内眦赘皮,导致眼美容手术效果大打折扣[1]。

收集2016-01—2018-02间在我院接受重睑术联合Park-Z成形术的60例内眦赘皮受术者的临床资料，进行回归性分析，以分析切开重睑成形术重睑术联合Park-Z成形术的效果，报告如下。

1 资料与方法1.1 一般资料本组60例受术者均为女性，年龄18～41岁，平均23.12岁。

单睑合并内眦赘皮37例，内双重睑合并内眦赘皮23例。

排除上睑皮肤松弛明显及瘢痕体质者。

1.2 方法1.2.1 切口设计平卧位，双眼向前平视，用尖头油笔依次设计重睑切口线和内眦部标记Park-z成形切口线：a标记点为泪湖最内侧端点皮肤。

“立体定位”内眦赘皮矫正术联合重睑成形术的临床效果观察摘要：目的：探讨“立体定位”内眦赘皮矫正术联合重睑成形术的临床疗效。

方法：选取2018年2月-2020年6月我院96例单睑伴内眦赘皮患者，分为观察组（n=48）与对照组（n=48）。

两组均行重睑成形术，观察组同期行“立体定位”内眦赘皮矫正术，对照组同期行Z成形内眦赘皮矫正术。

比较两组术后6个月疗效评价、术后并发症发生率及温哥华瘢痕量表（Vancouver scar scale，VSS）评分情况。

结果：本次96例患者均获有效随访。

术后6个月疗效评价，观察组优良率95.83%，对照组优良率87.50%，差异有统计学意义（P=0.024）。

观察组术后并发症发生率（4.17%）较对照组（16.67%）低，差异有统计学意义（P<0.05）。

观察组术后6个月瘢痕评分较对照组低，差异有统计学意义（P<0.05）。

结论：“立体定位”内眦赘皮矫正术联合重睑成形术疗效高，并发症发生率较低，远期瘢痕不明显，值得临床推广应用。

关键词：立体定位；临床效果[Abstract] Objective：To investigate the clinical effect of "stereotactic" epicanthoplasty combined with double eyelid plasty.Methods：96 patients with epicanthus in our hospital from February 2018 to June 2020 were selected and divided into observation group（n = 48）and control group（n = 48）.Double eyelid plasty was performed in both groups.The observation group received "three-dimensional positioning" epicanthoplasty at the same time，and the control group received Z-plasty epicanthoplasty at the same time.The curative effect evaluation，postoperative complication rate and Vancouver Scar Scale（VSS）score were compared between the two groups.Results：96 patients were followed up effectively.The excellent and good rate of the observation group was 95.83%，and that of the control group was 87.50%.The difference was statistically significant（P = 0.024）.The incidence of postoperative complications in the observation group（4.17%）was lower than that in the control group（16.67%）（P < 0.05）.The scar score of the observation group was lower than that of the control group at 6 months after operation，and the difference was statistically significant（P < 0.05）.Conclusion：stereotactic epicanthoplasty combined with blepharoplasty has high curative effect，low incidence of complications and no obvious long-term scar，which is worthy of clinical application.Key words：Stereotactic；clinical effect內眦赘皮在亚洲人群中发生率较高[1]，且在单睑人群中出现率更高，达70%以上[2]。

小切口重睑成形术同期内眦赘皮矫正［摘要］目的：观察小切口重睑成形术同期内眦赘皮矫正的美容效果。

方法：采用一段式或三点式小切口法，即于重睑线中部设计长5～10mm切口，或于重睑线内、中、外各设计长3～5mm切口，切开皮肤及皮下组织，经切口剪除少许眼轮匝肌及部分多余眶隔脂肪，以5-0丝线间断缝合，重睑形成。

继而行“△”形去皮鼻根部深层固定矫正内眦赘皮。

结果：26例获得较长期随访，随访时间6个月～3年，受访者均对手术效果表示满意。

结论：小切口重睑成形术同期内眦赘皮矫正美容效果肯定、方法简单。

Abstract:ObjectiveTo observe the cosmetic effect of the small incision for double upper eyelid plasty and homochronous epicanthus correction.MethodsWith a one-section small incision or three-point small incisions, i.e. with a 5-10 mm incision at the inner side of the midline of the double upper eyelid rim or with 3-5 mm incisions at the inner, middle and outside of the eyelid rim respectively, the skin and the subcutaneous tissues are incised and a small amount of orbicularis oculi and part of the excresent orbital septum fat were removed through the incisions and were sutured interruptedly with 5-0 silk threads. The double upper eyelids formed thereby. Thereafter, triangular section for the correction of epicanthus was performed.Results26 cases were followed up postoperatively for 6 to 36 months. Prognosis was judged by all to be excellent.ConclusionThe method is both simple and easy to perform.Key words:double upper eyelid plasty; small incision; epicanthus correction; homochronous operation笔者2003年以来行小切口重睑成形同期内眦赘皮矫正术获得满意效果，现报道如下。

倒L形法内眦赘皮矫正同期行重睑成形术的临床应用作者：彭旦生彭海涛刘晓春来源：《中国美容医学》2016年第01期[摘要]目的：探索一种新的内眦赘皮矫正同期行重睑成形术的方法。

方法：在内眦及下睑设计倒L形切口线，上睑设计重睑切口线，两切口线不相连接。

局麻后沿内眦切口线切开，皮下充分游离，剪断内眦处错构的眼轮匝肌，内眦韧带折叠缝合，向下睑延长切口，无张力缝合皮肤，然后行重睑术。

结果：本组36例患者术后随访了1～24个月，内眦明显开大，除1例术后早期内眦瘢痕较明显外，其它病例内眦瘢痕不明显，重睑线弧度自然流畅。

结论：倒L形法是矫正轻中度内眦赘皮的较好方法。

[关键词]内眦赘皮矫正；重睑成形术；内眦赘皮；倒L形切口[中图分类号]R622[文献标志码]A[文章编号]1008-6455（2016）01-0015-02内眦赘皮又称蒙古皱襞，是东方人眼睑特征之一。

行重睑成形术时，内眦赘皮常使上睑内侧皮肤皱襞过低，影响重睑形态的明显度Ⅲ。

目前内眦赘皮的矫正方法较多，均取得一定的治疗效果，但大多存在术后内眦瘢痕明显的缺点。

笔者应用倒L形法矫正内眦赘皮，同时行重睑术，取得了满意的效果，现报道如下。

1 材料和方法1.1 临床资料本组36例，均为女性，年龄16-35岁，平均26岁。

上睑均为单睑及正常组织结构，内眦赘皮类型：睑型29例，睑板型6例。

内眦赘皮严重程度分类：轻度21例，中度11例。

1.2 手术方法将赘皮向鼻侧牵拉，泪阜内侧2mm的内眦皮肤处定为原内眦点C，不牵拉内眦赘皮时，C 点在赘皮表面的投影点定为新内眦点A，B点位于重睑线在内眦部的隐性皱褶线上，AB两点的连线和睑裂水平线呈一定角度，A、B、C点组成倒L形，D点位于下睑缘下Imm处，长度根据术中“猫耳”情况适当调整。

距上睑缘5-7mm标记重睑切口线，其切口内侧端距B点约3-bmm。

局部浸润麻醉后，沿内眦设计线切开皮肤，分离皮肤与眼轮匝肌间的粘连，分离范围约为1.2cm×lcm，剪断眼轮匝肌浅头在内眦部分的错构附着部分，离断纵行的眼轮匝肌肌束，显露内眦韧带。

两种术式治疗内眦赘皮结合小切口重睑术的效果比较【摘要】目的：比较传统“Y-V成形术”和改良型“Y-V成形术”结合重睑术治疗内眦赘皮的临床疗效。

方法：选择2011年6月～2015年6月期间，我院收治的内眦赘皮病人80例为研究对象，根据手术方式的不同分为研究组和对照组。

对照组行“Y-V成形术”结合重睑术治疗；研究组行改良型“Y-V成形术”结合重睑术治疗。

在随访6个月后，将两组病人的治疗效果进行比较。

结果：研究组病人的总有效率为92.5%；对照组病人治疗的总有效率为67.5%。

研究组优于对照组，组间差异有统计学意义（P＜0.05）。

结论：在针对内眦赘皮的治疗上，改良型“Y-V成形术”具有切口设计简单，手术瘢痕较为隐蔽，切口形态较好的特点，有一定的临床参考价值。

【关键词】内眦赘皮；Y-V成形术；改良；疗效Effect comparison of two surgical treatment combined small incision double eyelid surgery on epicanthusShen LinxiongYueyang city the third people's hospital，Hunan Yueyang 414000[Abstract] Objective：To compare the clinical effects of traditional “Y-V plasty” and improved “Y-V plasty” combined with double eyelid surgery on epicanthus. Methods：The research object were80 cases of epicanthus patients admitted to our hospital from June 2011 - June 2015，and these patients were divided to research group and the control group according to different surgical methods. The control group was treated “Y-V plasty” combined double eyelid surgery；while the research group underwent improved “Y-V plasty” combined double eyelid surgery. After thefollow-up six months，the patient outcomes of two groups were compared. Results：The total effective rate was 92.5% in research group；and the total effective rate was 67.5% in control group. The research group was better than the control group，difference between the two groups was statistically significant（P <0.05）. Conclusions：In the treatment of epicanthus，improved “Y-V plasty” was featured by simple design of incision，subtle surgical scar，and better shape of incision，which has some clinical reference value.[Key words]：epicanthus；Y-V plasty；Improvement；Efficacy内眦赘皮在东方人群中的发生率高达50%，指的是在靠近内眦处的一垂直向内的皮肤皮蹼或褶皱，部分可对泪埠造成掩盖，影响审美。

临床应用双V法内眦赘皮矫正联合重睑成形术的分析【摘要】目的：分析双V法内眦赘皮矫正联合重睑成形术的临床应用效果。

方法：选取我院收治的32例伴有内眦赘皮的单睑患者作为研究对象，所有患者均行双V法内眦赘皮矫正联合重睑成形术，术后随访1年，分析患者的临床效果及满意度。

结果：重睑成形术后，32例患者中，两侧重睑形态对称且自然者29例，占比90.6%；重睑形成但效果不佳者3例，占比9.4%；无部分重睑或无重睑病例。

内眦赘皮矫正术后，内眦形态良好、泪阜完全外露、无手术疤痕者27例，占比84.4%；内眦形态不佳、泪阜部分外露、赘皮部分回缩、有轻微疤痕者5例，占比15.6%；无赘皮复发、有明显疤痕病例。

患者满意度为93.8%（30/32）。

结论：临床应用双V法内眦赘皮矫正联合重睑成形术的效果满意，值得推广与应用。

【关键词】双V法内眦赘皮矫正，重睑成形术；内眦赘皮；单睑内眦赘皮多位于内眦角前方，对内眦的正常形态与视野均造成了一定的影响[1]。

近年来，内眦赘皮矫正联合重睑成形术在临床上获得了广泛应用，也取得了明显疗效。

本研究为了进一步分析双V法内眦赘皮矫正联合重睑成形术的临床应用效果，选取了我院2015年9月到2016年9月期间收治的32例伴有内眦赘皮的单睑患者的临床资料进行回顾性分析，现将对比结果报道如下。

1 资料与方法1.1 临床资料选取我院收治的32例伴有内眦赘皮的单睑患者作为研究对象，其中男3例，女29例；年龄23~47岁，平均（28.1±3.6）岁；按照内眦赘皮分类，分为睑型5例，睑板型27例；按照赘皮严重程度，分为轻度4例，中度22例，重度6例。

1.2 方法所有患者均行双V法内眦赘皮矫正联合重睑成形术。

（1）切开重睑成形术设计：患者取仰卧位，定点画线，重睑线宽度距上睑缘约7mm，可视患者要求适度调整宽度，再根据患者眼形与要求设计成平行型、开扇型、新月型，观察长度、宽度与弧度，患者满意后用碘酊固定。