Heltzer J M, Ellis D S, Stewart W B, Spencer W H
Department of Ophthalmology, California Pacific Medical Center, San Francisco, 94115, USA.
Ophthalmic Plast Reconstr Surg. 1999 Nov;15(6):438-41. doi: 10.1097/00002341-199911000-00014.
Transconjunctival blepharoplasty is becoming the approach of choice for many cosmetic surgeons. The authors describe a case of a diffuse, multinodular eyelid lipogranuloma following transconjunctival blepharoplasty, after which the unsutured wound was dressed with a topical ointment.
Report of clinical course and histopathologic findings.
A patient developed multiple firm, nontender masses of the left lower eyelid that enlarged despite topical and systemic medical therapy. Prior to referral, the progressive lesions had recurred despite three successive attempts at surgical eradication. Histopathologic examination of excised tissue demonstrated a multifocal lipogranulomatous inflammation consistent with reaction to retained ointment.
Sclerosing lipogranulomas are a known complication of intradermal lipid injection, as well as a late complication of sinus surgery after postoperative nasal packing with ointment-saturated gauze. The application of a topical ointment should be avoided until after transconjunctival lower blepharoplasty unless wound closure is secure or until conjunctival epithelialization is complete.
经结膜睑成形术正成为许多整形外科医生的首选手术方法。作者描述了1例经结膜睑成形术后弥漫性、多结节性眼睑脂肪肉芽肿病例，术后未缝合的伤口用外用软膏进行了包扎。
临床病程及组织病理学结果报告。
1例患者左眼下睑出现多个质地坚硬、无压痛的肿块，尽管进行了局部和全身药物治疗，肿块仍不断增大。在转诊之前，尽管连续3次尝试手术切除，进展性病变仍复发。切除组织的组织病理学检查显示为多灶性脂肪肉芽肿性炎症，符合对残留软膏的反应。
硬化性脂肪肉芽肿是皮内脂质注射的一种已知并发症，也是术后用软膏浸润纱布进行鼻腔填塞的鼻窦手术后的一种晚期并发症。除非伤口闭合牢固或结膜上皮化完全完成，否则在经结膜下睑成形术后应避免使用外用软膏。
