Study On The Influence Of Exophthalmos On Double Eyelid Incision

Purpose:By the use of the double eyelid width,surgical satisfaction,postoperative complications and improvement of facial aesthetics,the postoperative effects of double eyelid surgery with different exophthalmos were compared,and the influence of exophthalmos on double eyelid surgery by incision was discussed to explore the clinical use of this method to double eyelid surgery with high exophthalmos need to make changes.Method:A total of 100 eyes were selected from 50 female beauty seekers with single eyelid from the Department of Aesthetic Plastic Surgery,Affiliated Hospital of Qingdao University from June 2021 to March 2022.All the beauty seeking patients were treated by the same senior physician in our hospital with improved incision double eyelid surgery with orbital septal.The ocular protrusion of both eyes was measured by HETEL ophthalmoscope before surgery.Both eyes at 12-15mm are deemed as normal group(n=26),both eyes at 16-18mm are deemed as mild protrusion group(n=14)and both eyes at 19-22mm are deemed as severe protrusion group(n=10).At the same time take a frontal eye opening photo.After the preoperative design was completed,the double eyelid width above the pupil when the eyes were closed was recorded,and the patients were given unified postoperative care.Six months after surgery,the width of the double eyelid above the pupil of the patients when opening and closing the eyes was measured,and the photos of the front eye opening were taken,and the"Satisfaction questionnaire of the double eyelid patients in the Affiliated Hospital of Qing Dao University"was published.The questionnaire included the self-evaluation scale for the effect of open double eyelid surgery,which was divided into four levels:Obvious improvement,mild improvement,average improvement,no improvemen,and the improvement rate was defined as the number of obvious improvement and mild improvement/overall number.Both eyes were scored on a scale of 0 to 10 based on the standardized visual effects scale,with higher scores indicating more serious complications.Photoshop was used to select preoperative and postoperative eye opening photos of patients.The values from the upper eyelid margin to the lower chin/upper eyelid margin hairline were measured and calculated.According to facial standard aesthetics.Set period=|preoperative facial aesthetics value postoperative value-1.618-1.618|-||/1.618.SPSS25.software was used for statistical analysis of the data.Results:1.The incisions of all cases were healed in the first stage,and no complications such as postoperative infection,eye closing dysfunction,and incision dehiscence occurred.2.There was no statistical significance in double eyelid width between the three groups(all P>0.05);The double eyelid width in normal group was smaller than that in mild protrusion group(F=23.230,P<0.0167 for both eyes),and the double eyelid width in mild protrusion group was smaller than that in severe protrusion group(F=47.701,P<0.0167 for both eyes).3.There was no significant difference in the rate of facial aesthetic improvement among the three groups(F=0.591,P=0.558>0.05).4.There were statistically significant differences in the sense of strip of meat and scar between the two groups(F=20.499,33.450,F=28.530,32.509,P<0.05).The strip sensation and scar in both eyes in normal group were less than those in mild protrusion group(all P<0.0167).The sense of strip of flesh and scar in both eyes in the mild protrusion group were smaller than those in the severe protrusion group(all P<0.0167),and the difference was statistically significant.5.The normal period is higher than mild outstanding group and severe group(χ~2=7.248,χ~2=7.893,P=0.007,P=0.005<0.0167),mild and severe group there was no statistically significant difference period(χ~2=0.046,P=0.831>0.0167)Conclusion:1.The higher the ocular protrusion,the wider the double eyelid width after surgery;The heavier the"fleshy feeling"and scar of double eyelid,the lower the satisfaction of patients.There was no significant difference in the dilatation of palpebral fissure with different levels of exophthalmia.2.Open double eyelid surgery for patients with high ocular protrusion should narrow the design width,reduce the amount of peeling,fully open the adhesion between orbital septa and the front of the blepharon,and make the suture tension evenly distributed during suture;If the effect of double eyelid is not satisfactory due to over-width of double eyelid and severe upturned ciliary eyelid during intraoperative suspension from the posterior wall of orbital septum,the suspension position should be changed to tarsus or Superficial fascia of tarsal plate When the ocular protrusion of the patient is more than22mm,the effect and complications of surgery should be positively discussed with the patient,and surgery should be avoided.