Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2009 Nov-Dec;25(6):440-4. doi: 10.1097/IOP.0b013e3181b80eb8.
To describe the use of hyaluronic acid gel for upper eyelid filling, contouring, and rejuvenation.
In this consecutive, retrospective, interventional case series, standard serial puncture injections with preperiosteal placement of filler were administered at the superior orbital rim. Outcome measures included classification of upper eyelid volume deficiency as I) medial A-shaped hollow, II) generalized hollow, III) postblepharoplasty volume loss, and IV) upper eyelid hooding with subbrow volume deflation; volume of filler used; masked, independent assessment of pretreatment and posttreatment photographs; patient satisfaction; and complications.
Twenty-seven patients were included with a mean follow-up of 13 months. More than 85% were white women with a mean age of 51 years (range, 24-65 years). Five patients were classified as type I, 8 as type II, 11 as type III, and 3 as type IV. The mean volume of filler used was 0.4 ml/eyelid (range, 0.1-1 ml). Photographic assessment showed improved static upper eyelid contour in 23 patients (85%), little change in 3 patients (11%), and deterioration in 1 patient (4%). Twenty-six patients (96%) were satisfied with the treatment, although 5 (19%) requested additional filler and 1 patient underwent dissolution within 3 months. Two of the 3 type IV patients still required blepharoplasty/ptosis surgery. All patients developed mild bruising and swelling but no discoloration or lumpiness.
Hyaluronic acid filler is an effective means of rejuvenating the upper eyelid and is particularly successful in patients with medial/generalized upper eyelid hollowing, or significant postblepharoplasty upper eyelid show. A blepharoplasty/brow lift/ptosis procedure is still frequently required for hooding due to subbrow deflation (type IV).
描述透明质酸凝胶在上眼睑填充、塑形和年轻化中的应用。
在这项连续的、回顾性的、干预性病例系列研究中，在眶上缘行标准连续穿刺注射，将填充物置于骨膜前。观察指标包括：上睑体积不足的分类为 I）内侧 A 形凹陷，II）弥漫性凹陷，III）重睑术后体积损失，IV）上睑伴眉下体积凹陷的遮盖；填充物的用量；对治疗前后照片进行盲法、独立评估；患者满意度；以及并发症。
共纳入 27 例患者，平均随访 13 个月。超过 85%的患者为白人女性，平均年龄 51 岁（范围，24-65 岁）。5 例患者为 I 型，8 例为 II 型，11 例为 III 型，3 例为 IV 型。平均每侧眼睑填充物用量为 0.4ml（范围，0.1-1ml）。23 例（85%）患者的静态上睑轮廓得到改善，3 例（11%）患者无明显变化，1 例（4%）患者恶化。26 例（96%）患者对治疗满意，尽管 5 例（19%）要求额外填充，1 例在 3 个月内溶解。3 例 IV 型患者中，仍有 2 例需要行重睑术/上睑下垂手术。所有患者均出现轻度瘀斑和肿胀，但无变色或肿块。
透明质酸填充物是一种有效改善上睑年轻化的方法，特别适用于内侧/弥漫性上睑凹陷或重睑术后上睑明显损失的患者。由于眉下凹陷（IV 型），仍经常需要行上睑成形术/眉提升术/上睑下垂手术。
