| Objective:By comparing the postoperative morphology,complication rate,and patients satisfaction of the orbital septum double eyelid surgery(orbital septum-skin suture)and the classic double eyelid surgery(pretarsal fascia-skin suture),we analyze the indications and limitations of the two types of double eyelid surgery,explore the clinical efficacy of orbital septum double eyelid surgery,and provide clinical reference.Methods:Sixty female patients with single eyelid in Affiliated Hospital of Qingdao University from July 2019 to June 2020 were analyzed on whom blepharoplasty was performed.According to the contents of the admission record,the contents of the postoperative operation record and the answer of the surgeon,the surgical method used by the patient was determined.The patients who were sutured in skin-orbital septum-skin method were divided into the orbital septum group,and the patients who were sutured in skin-pretarsal fascia-skin method were divided into the tarsal group.There were 38 patients in the orbital septum group with 76 eyes,22 patients in the tarsal group with 44 eyes.Among them,18 patients(36 eyes)in the orbital septum group underwent epicanthoplasty,and 9 patients(18 eyes)in the tarsal group underwent epicanthoplasty.After 7 days,1 month,and 6 months after the operation,the photographs of them were archived,and the "Double Eyelid Surgery Questionnaire" was issued 6 months after the operation(see Appendix 1).The contents of the questionnaire include: Self-evaluation of the improvement of double eyelid after 6 months is divided into 5 levels,which are complete improvement(achieving the best improvement effect),partial improvement(the appearance is significantly improved compared to the preoperative appearance,but it is not completely ideal),improved(the appearance is improved compared with the preoperative,but a more ideal appearance can be achieved by adding corrective surgery),no improvement(the appearance does not have any improvement,which means the failure of the operation),worse than the preoperative(the appearance is worse compared to the operation).Counting the number of people in each scoring level in the orbital septum group and the tarsal group,we calculate the improvement rate,the obvious improvement rate and the complete improvement rate.The improvement rate =(completely improved cases + obvious improved cases + improved cases)/ total number;obvious improvement rate =(completely improved cases + obvious improved cases)/total number;complete improvement rate = completely improved cases / the total number.According to the scoring standard picture attached to the questionnaire,the patient scored the degree of double eyelid scars,"sausage appearance",shallowness or disappearance of double eyelid folds,and canthal scars at 6 months after double eyelid surgery in their left or right eyes,the score range from 0 to 10 in which the 0 points means no complications,and 10 points means serious complications.SPSS26.0 was used to statistically analyze the data,and the clinical effects of double eyelid surgery with orbital septum incision and taral were compared and discussed.Results:After comparison of photos before operation,7 days after operation,1 month after operation,and 6 months after operation,there were no complications such as incision dehiscence,upper eyelid retraction,incomplete eyelid closure or postoperative infection in the two groups.At 6 months after double eyelid surgery,the total number of improvement cases in the orbital septum group was 38 cases,and the improvement rate was 100%;the total number of improvement cases in the tarsal group was 22 cases,and the improvement rate was 100%;the total number of obvious improvement cases in orbital septum group was 35 cases,the obvious improvement rate was 92%,the total number of obvious improvement cases in the tarsus group was 20 cases,and the obvious improvement rate was 91%,the difference was not statistically significant(P>0.05);the number of complete improvement cases in the orbital septum group was 20 cases,and the complete improvement rate was 53%,the number of complete improvement cases in the tarsus group was 5,and the complete improvement rate was 23%,the difference was statistically significant(P<0.05).Among 120 eyes in the study,the total number of the orbital septum group is 76 cases.The scores were ranged from 0 to 4,with an average score of 2.08 points,of which 8 cases were 0 points and 2 cases were 4 points.The scores of double eyelid scars in the tarsal group were ranged from 0-6 points,with an average score of 3.72 points,of which 0 points in 4 cases,and 6 points in 4 cases.The degree of scarring in the orbital septum group was lighter than that in the tarsal group at 6 months after surgery,and the difference was statistically significant.Significance(P<0.05).The scores of "sausage appearance" in the orbital septum group ranged from 0 to 2 points,with an average score of 0.18,of which 66 cases were 0 points,and 6 cases were 2 points.The tarsal group scores were ranged from 0 to 3 points,with an average score of 0.86 points,of which 0 points in 18 cases,3 points in 6 cases.The degree of scar in the orbital septum group was less than that in the tarsus group at 6 months after the operation.In 120 cases,the double eyelid disappearance score was 0.In 36 cases taking epicanthoplasty of76 cases who are in orbital septum group,4 cases had canthal scars,and in 18 cases taking epicanthoplasty of 44 cases who are in tarsal group,2 cases had canthal scars.Conclusion:Patients in the orbital septum group and the tarsal group had good clinical improvement in the postoperative self-evaluation,and the complete improvement rate of the patients in the orbital septum group was better than that of the tarsal group.The degree of scars and "sausage appearance" in the orbital septum group and the tarsal group were lighter after surgery.No obvious complications occurred in the two groups.The scars and "sausage appearance" in the orbital septum group were better than those in the tarsal group after 6 months.It shows that the double eyelid surgery with orbital septum has good clinical effect and it is worthy of continuous promotion. |
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