Division of Plastic Surgery, Faculty of Medicine, Dalhousie University, Room 4447, Halifax Infirmary, 4th Floor, Plastic Surgery, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada.
Division of Plastic Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Aesthetic Plast Surg. 2021 Oct;45(5):2190-2198. doi: 10.1007/s00266-021-02131-8. Epub 2021 Feb 4.
Our objective is to evaluate the evidence on the aesthetic effect and complications of skin-OOM strip resection compared to skin only upper blepharoplasty.
A systematic search of EMBASE, PubMed, Cochrane and Google Scholar databases was performed using our search strategy through to 31 December 2019. Only comparative studies of the two upper blepharoplasty techniques were included. Three reviewers performed study selection process, data extraction, and quality assessment.
A total of six articles were eligible for final inclusion. The included studies consist of two controlled retrospective cohorts and four small randomized controlled studies (RCT). Three of which, were double blinded. Those RCTs were assigned level 2 evidence due to small size and methodological limitations. The sample size of included was studies 407 in the two retrospective studies and 57 in the four RCTs. The outcomes showed that resection of OOM along with skin in upper blepharoplasty showed no difference in long-term aesthetic outcome when skin only procedure is performed. Muscle strip resection was associated with initially higher ophthalmological morbidity (edema, bruising, pain, dry eye, sluggish eye closure and lagopthalmos). Those resolved a few weeks later with conservative treatment.
The resection of OOM along with skin in upper blepharoplasty showed no difference in long-term aesthetic outcome and was associated with initially higher ophthalmological morbidity compared to skin only procedure. While we are not suggesting that OOM resection is never required, the evidence strongly support its preservation during standard upper blepharoplasty.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
我们的目的是评估皮肤-OOM 条带切除术与单纯皮肤的上睑成形术相比的美学效果和并发症的证据。
通过我们的搜索策略，对 EMBASE、PubMed、Cochrane 和 Google Scholar 数据库进行了系统搜索，截至 2019 年 12 月 31 日。仅纳入了两种上睑成形术技术的比较研究。三名评审员进行了研究选择过程、数据提取和质量评估。
共有 6 篇文章符合最终纳入标准。纳入的研究包括两项对照回顾性队列研究和四项小型随机对照研究（RCT）。其中三项为双盲 RCT。由于样本量小和方法学上的局限性，这些 RCT 被评为 2 级证据。纳入研究的样本量为两项回顾性研究中的 407 例和四项 RCT 中的 57 例。研究结果表明，在上睑成形术中切除 OOM 与单纯皮肤切除相比，在长期美学效果方面没有差异。肌肉条带切除术与最初更高的眼科发病率（水肿、瘀伤、疼痛、干眼症、眼睛闭合缓慢和眼球运动障碍）相关。这些在保守治疗后几周内得到解决。
在上睑成形术中切除 OOM 与单纯皮肤切除相比，在长期美学效果方面没有差异，与单纯皮肤切除相比，最初的眼科发病率更高。虽然我们并不是说 OOM 切除术从不需要，但证据强烈支持在标准的上睑成形术中保留它。
证据等级 III：本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266 。
