Carter S R, Seiff S R, Choo P H, Vallabhanath P
Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
Ophthalmology. 2001 Mar;108(3):437-41. doi: 10.1016/s0161-6420(00)00593-5.
The effect of transconjunctival blepharoplasty alone compared with transconjunctival blepharoplasty and CO(2) laser skin resurfacing on lower lid bulging and wrinkles was examined.
Randomized clinical trial.
Forty-four subjects, including 13 men and 31 women.
Subjects were prospectively randomly assigned into two groups: (1) transconjunctival blepharoplasty with immediate CO(2) laser resurfacing or (2) transconjunctival blepharoplasty with CO(2) laser resurfacing 2 months later. Standardized photographs were taken before and 2 months after each procedure. A trained, masked observer graded the photographs.
Bulging and wrinkles of the medial, central, and lateral portions of the lower lid were scored and compared at specified end points.
Transconjunctival blepharoplasty alone resulted in an improvement in lower lid bulging in 92% of subjects, whereas lower lid wrinkling worsened in 46%. When transconjunctival blepharoplasty was performed with simultaneous CO(2) laser resurfacing, or with CO(2) laser resurfacing 2 months later, a statistically significant improvement in wrinkles occurred (chi square = 20.625; P < 0.0005). The timing of the procedures had no statistically significant effect on final outcome. No subject had lower lid retraction develop.
Transconjunctival blepharoplasty and adjunctive CO(2) laser resurfacing represents an excellent alternative to transcutaneous lower blepharoplasty. The procedure addresses lower lid wrinkles, skin redundancy, and fat herniation without a scar and with little risk of lower lid retraction.
研究单纯经结膜睑成形术与经结膜睑成形术联合二氧化碳激光皮肤磨削术对下睑膨隆和皱纹的影响。
随机临床试验。
44名受试者，包括13名男性和31名女性。
受试者被前瞻性随机分为两组：（1）经结膜睑成形术联合即刻二氧化碳激光磨削术；（2）经结膜睑成形术2个月后行二氧化碳激光磨削术。在每次手术前和术后2个月拍摄标准化照片。由一名经过培训的、不知情的观察者对照片进行评分。
在特定终点对下睑内侧、中央和外侧部分的膨隆和皱纹进行评分并比较。
单纯经结膜睑成形术使92%的受试者下睑膨隆得到改善，而46%的受试者下睑皱纹加重。当经结膜睑成形术与同期二氧化碳激光磨削术或2个月后行二氧化碳激光磨削术联合进行时，皱纹有统计学意义的改善（卡方 = 20.625；P < 0.0005）。手术时机对最终结果无统计学意义的影响。没有受试者出现下睑退缩。
经结膜睑成形术联合辅助性二氧化碳激光磨削术是经皮肤下睑成形术的极佳替代方法。该手术可解决下睑皱纹、皮肤冗余和脂肪疝出问题，无瘢痕且下睑退缩风险极小。
