Department of Ophthalmology, National Medical Institute of the Ministry of Interior and Administration in Warsaw, Woloska 137 Str, 02-507, Warsaw, Poland.
Department of Neurology, National Medical Institute of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland.
Int Ophthalmol. 2023 Nov;43(11):3979-3987. doi: 10.1007/s10792-023-02801-3. Epub 2023 Jul 7.
Even though upper blepharoplasty is one of the most commonly performed procedures in esthetic surgery, there is still no consensus regarding the management of the orbicularis oculi muscle (OOM).
To compare outcomes of upper eyelid blepharoplasty with or without OOM excision using surface electromyography in a 12 month follow-up.
A prospective, randomized, single-blinded comparative split-face study was conducted on 26 patients with dermatochalasis. Skin-only upper blepharoplasty was performed on a randomly selected side, and on the contralateral side, a strip of OOM was resected as well. The functional outcomes were assessed using sEMG, and the esthetics were evaluated independently by the operating surgeon, blinded patients, and three blinded ophthalmic surgeons.
The RMS values of maximal contraction of the OOM were statistically significantly lower two weeks after blepharoplasty than the values before surgery in both groups (p < 0,001) and reached the preoperative values after six months. Lagophthalmos occurred in 2 cases in the skin-muscle group (7.69%), and no incidence of lagophthalmos was observed in the skin group. There were comparable esthetic outcomes on both operated sides.
This study is an objective and quantitative report using surface electromyography on upper blepharoplasty with or without a strip of OOM excision. Our results showed that OOM fully recovers after the stripping procedure. The resection of the skin-OOM flap showed no difference in long-term cosmetic results. Therefore, we recommend OOM preservation during upper blepharoplasty unless muscle excision is well-grounded.
尽管上睑成形术是美容手术中最常进行的手术之一，但对于眼轮匝肌（OOM）的处理仍没有共识。
通过 12 个月的随访，使用表面肌电图比较上睑成形术联合或不联合眼轮匝肌切除术的效果。
对 26 例皮肤松弛患者进行前瞻性、随机、单盲对照分面研究。随机选择一侧行单纯皮肤性上睑成形术，对侧行眼轮匝肌带切除术。使用 sEMG 评估功能结果，由手术医生、盲法患者和 3 名盲法眼科医生独立评估美容效果。
两组患者术后两周眼轮匝肌最大收缩 RMS 值均明显低于术前（p<0.001），并在术后 6 个月恢复至术前水平。皮肤-肌肉组有 2 例（7.69%）发生睑裂闭合不全，皮肤组无睑裂闭合不全发生。两侧手术效果相当。
本研究是一项使用表面肌电图对上睑成形术联合或不联合眼轮匝肌带切除术的客观和定量报告。我们的结果表明，眼轮匝肌在剥离后可完全恢复。切除皮肤-眼轮匝肌瓣在长期美容效果方面没有差异。因此，除非肌肉切除有充分依据，我们建议在上睑成形术中保留眼轮匝肌。
