From the Division of Plastic Surgery, Department of Surgery, University of British Columbia.
Plast Reconstr Surg. 2020 Feb;145(2):306e-315e. doi: 10.1097/PRS.0000000000006484.
Patients with horizontal lower lid laxity undergoing lower lid blepharoplasty are at a high risk for lid malposition. Prophylactic correction of horizontal lower lid laxity during blepharoplasty may alleviate this risk. In this article, the authors describe a novel lower lid blepharoplasty technique, the KS-pexy (named after its originators, Kuhnt and Szymanowski), for correcting horizontal lower lid laxity.
All cases of KS-pexy between September of 2009 and June of 2018 from an aesthetic practice were reviewed retrospectively. All patients were diagnosed with horizontal lower lid laxity and requested lower lid blepharoplasty for aesthetic concerns. Patient demographics, clinical presentation, procedure details, and intraoperative findings were analyzed.
Sixty-two patients underwent KS-pexy performed by the senior author. The average follow-up was 41.1 months, ranging from 2 to 107 months. Thirteen patients had a negative vector, 54 patients received a KS-pexy in combination with another facial procedure, and 14 patients had their KS-pexy as a secondary procedure. The overall success rate was 96.8 percent. The complication profile was as follows: chemosis (27.4 percent), new-onset dry eyes persisting longer than 8 weeks (6.5 percent), temporary lower eyelid malposition (4.8 percent), lower eyelid malposition requiring surgical intervention (3.2 percent), poor scar quality (1.6 percent), lower lid abscess (1.6 percent), transient conjunctivitis (1.6 percent), lateral fat compartment swelling (1.6 percent), canthopexy dehiscence (1.6 percent), hordeolum (1.6 percent), and temporary V2 paresthesia (1.6 percent).
The KS-pexy is an effective means to treat horizontal eyelid laxity prophylactically in patients requesting lower eyelid blepharoplasty for aesthetic reasons.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
行下睑成形术的水平性下睑松弛患者存在眼睑位置不正的高风险。在眼睑成形术中预防性矫正水平性下睑松弛可能会降低这种风险。本文作者介绍了一种新颖的下睑成形术技术，KS-皮瓣成形术（以其发明者 Kuhnt 和 Szymanowski 的名字命名），用于矫正水平性下睑松弛。
回顾性分析了 2009 年 9 月至 2018 年 6 月间一家美容诊所所有行 KS-皮瓣成形术的病例。所有患者均被诊断为水平性下睑松弛，并因美容原因要求行下睑成形术。分析患者的人口统计学资料、临床表现、手术细节和术中发现。
62 例患者由资深作者行 KS-皮瓣成形术。平均随访时间为 41.1 个月，范围为 2-107 个月。13 例患者存在负向量，54 例患者行 KS-皮瓣成形术联合其他面部手术，14 例患者行 KS-皮瓣成形术作为二期手术。总体成功率为 96.8%。并发症情况如下：球结膜水肿（27.4%）、新出现的干眼症持续时间超过 8 周（6.5%）、暂时性下睑位置不正（4.8%）、需要手术干预的下睑位置不正（3.2%）、瘢痕质量差（1.6%）、下睑脓肿（1.6%）、一过性结膜炎（1.6%）、外侧脂肪间隔肿胀（1.6%）、睑缘切开术裂开（1.6%）、麦粒肿（1.6%）和暂时性 V2 感觉异常（1.6%）。
KS-皮瓣成形术是一种有效方法，可预防性治疗因美容原因要求行下睑成形术的患者的水平性眼睑松弛。
临床问题/证据水平：治疗性，IV。
