Seckel B R, Kovanda C J, Cetrulo C L, Passmore A K, Meneses P G, White T
Department of Plastic and Reconstructive Surgery, Lahey Clinic Medical Center, Burlington, Mass 01805, USA.
Plast Reconstr Surg. 2000 Oct;106(5):1127-41; discussion 1142-5. doi: 10.1097/00006534-200010000-00024.
Carbon dioxide (CO2) laser blepharoplasty with orbicularis oculi muscle tightening and periorbital skin resurfacing is a safe procedure that produces excellent aesthetic results and diminishes the occurrence of complications associated with skin and muscle resection in the lower lid, particularly permanent scleral show and ectropion. The authors present a review of 196 cases of carbon dioxide laser blepharoplasty and periocular laser skin resurfacing performed at their center from April of 1994 to September of 1998. Of these cases, 113 patients underwent four-lid blepharoplasty, 59 underwent upper lid blepharoplasty only, and 24 underwent lower lid blepharoplasty only. Prophylactic lateral canthopexy was performed in 24 patients. Concomitant procedures (brow lift/rhytidectomy/rhinoplasty) were performed in 92 patients. The carbon dioxide laser blepharoplasty procedure resulted in no injuries to the globe, cornea, or eyelashes. Combined with laser tightening of the orbicularis oculi muscle and septum and periocular skin resurfacing, the transconjunctival approach to lower blepharoplasty preserves lower lid skin and muscle. Elimination of the traditional scalpel skin/muscle flap procedure results in a dramatically lower complication rate, particularly with regard to permanent ectropion and scleral show. Laser shrinkage of the orbicularis muscle and septum through the transconjunctival incision enables the correction of muscle aging changes such as orbicularis hypertrophy and malar festoons. The addition of periocular resurfacing enables the correction of skin aging changes of the eyelid that are not addressed by traditional scalpel blepharoplasty. In addition, lateral canthopexy constitutes an important adjunct to the laser blepharoplasty procedure for the correction of lower lid canthal laxity.
二氧化碳激光睑成形术联合眼轮匝肌收紧及眶周皮肤表面重塑是一种安全的手术，能产生极佳的美学效果，并减少下睑皮肤和肌肉切除相关并发症的发生，尤其是永久性巩膜外露和睑外翻。作者回顾了1994年4月至1998年9月在其中心进行的196例二氧化碳激光睑成形术及眶周激光皮肤表面重塑手术。其中，113例患者接受了四睑睑成形术，59例仅接受了上睑睑成形术，24例仅接受了下睑睑成形术。24例患者进行了预防性外眦固定术。92例患者同时进行了其他手术（提眉术/除皱术/隆鼻术）。二氧化碳激光睑成形术未对眼球、角膜或睫毛造成损伤。经结膜途径进行下睑睑成形术联合眼轮匝肌和眶隔激光收紧及眶周皮肤表面重塑，保留了下睑皮肤和肌肉。摒弃传统的手术刀皮肤/肌肉瓣手术可显著降低并发症发生率，尤其是永久性睑外翻和巩膜外露。通过经结膜切口对眼轮匝肌和眶隔进行激光收缩，可纠正肌肉老化改变，如眼轮匝肌肥大和颧部皮肤松弛。眶周表面重塑可纠正传统手术刀睑成形术无法解决的眼睑皮肤老化改变。此外，外眦固定术是激光睑成形术纠正下睑外眦松弛的重要辅助手段。
