CAJ | 학술논문

目的探讨重睑成形术后上睑缘外翻及重睑线凹陷过深2项不良形态的修复效果以及其成因与预防.方法对重睑成形术后上睑不良形态分型与分级,并手术修复.将上睑由内眦至外眦均分为Ⅰ、Ⅱ、Ⅲ区.(1)针对上睑缘外翻畸形者测量三区睫毛根部提升角(lift-up angle,LA),平视位、上视位中央区睑缘露白相对面积(relative area of exposed central eyelid margin,RA).(2)对重睑线凹陷过深者测量三区重睑线处凹陷相对深度(relative depth of double eyelid fold,RD).结果 (1)上睑缘外翻畸形18只眼,修复术前与术后6个月分级差异有统计学意义(P＜0.05);Ⅱ区LA由(95.11±9.66)°降至(79.50±6.71)°(P＜0.05),Ⅰ、Ⅲ区差异无统计学意义(P＞0.05);平视位RA由(4.22±0.66)×10-2降至(0.23±0.22)×10-2 (P＜0.05);上视位RA由(4.51±0.65)×10-2降至(0.59±0.21)×10-2 (P＜0.05).(2)重睑线凹陷过深畸形24只眼,修复术前与术后6个月分级差异有统计学意义(P＜0.05);Ⅰ区RD由(7.14±0.89)×10-2降至(1.70±0.61)×10-2 (P＜0.05),Ⅱ区RD由(8.90±0.90)×10-2降至(2.28±0.63)×10-2 (P＜0.05),Ⅲ区差异无统计学意义(P＞0.05).结论重睑成形术后的不良形态值得临床重视,合理设计手术矫正可有效改善外观,并减轻不适感.
목적 탐토중검성형술후상검연외번급중검선요함과심2항불량형태적수복효과이급기성인여예방.방법 대중검성형술후상검불량형태분형여분급,병수술수복.장상검유내자지외자균분위Ⅰ、Ⅱ、Ⅲ구.(1)침대상검연외번기형자측량삼구첩모근부제승각(lift-up angle,LA),평시위、상시위중앙구검연로백상대면적(relative area of exposed central eyelid margin,RA).(2)대중검선요함과심자측량삼구중검선처요함상대심도(relative depth of double eyelid fold,RD).결과 (1)상검연외번기형18지안,수복술전여술후6개월분급차이유통계학의의(P＜0.05);Ⅱ구LA유(95.11±9.66)°강지(79.50±6.71)°(P＜0.05),Ⅰ、Ⅲ구차이무통계학의의(P＞0.05);평시위RA유(4.22±0.66)×10-2강지(0.23±0.22)×10-2 (P＜0.05);상시위RA유(4.51±0.65)×10-2강지(0.59±0.21)×10-2 (P＜0.05).(2)중검선요함과심기형24지안,수복술전여술후6개월분급차이유통계학의의(P＜0.05);Ⅰ구RD유(7.14±0.89)×10-2강지(1.70±0.61)×10-2 (P＜0.05),Ⅱ구RD유(8.90±0.90)×10-2강지(2.28±0.63)×10-2 (P＜0.05),Ⅲ구차이무통계학의의(P＞0.05).결론 중검성형술후적불량형태치득림상중시,합리설계수술교정가유효개선외관,병감경불괄감.
Objective To discuss the unsatisfied appearance of upper eyelid after double eyelid blepharoplasty,and to present its therapeutic schedule,curative effects,pathogenesis and precautions.Methods All eyes were classified into two types and repaired.Each upper eyelid was horizontally and equally divided into three sections named as Ⅰ,Ⅱ,and Ⅲ from inner to outer canthus.The lift-up angles (LA) of the 3 sections,the relative areas of exposed central eyelid margin (RA) of headup position and looking-up were measured on the upper eyelid margin ectropion of eyes.The relative depth of double-eyelid fold (RD) of 3 sections were measured on the double-eyelid fold depression of eyes.Results Six months after the repair,the grades of both types were significantly different from the grades before (P＜0.01).Concerning 18 upper eyelid margin ectropion eyes,LA in section Ⅱ changed from (95.11±9.66)° to (79.50≈6.71)° (P＜0.05) while there were no significant change in sections Ⅰ and Ⅲ (P＞0.05),and the RA of head-up position changed from (4.22±0.66) × 10-2 to (0.23± 0.22) × 10-2 while the RA of looking-up changed from (4.51 ± 0.65) × 10-2 to (0.59 ±0.21) × 10-2 (p＜ 0.05).Concerning 24 double-eyelid fold depression eyes,the RD in section Ⅰchanged from (7.14±0.89) × 10-2 to (1.70±0.61) × 10-2 and the RD in section Ⅱ changed from (8.90±0.90) × 10-2 to (2.28±0.63) × 10-2 (P＜0.05),while there were no significant change in section Ⅲ (P＞0.05).Conclusions Unsatisfied appearance after double eyelid blepharoplasty must be paid highly attention in clinical setting,and the appearance and symptoms can be effectively improved by using proper surgical procedures.