The Clinical Application Of Autologous Fat Filling Combined With Ligament Release To Correct Tear Trough Deformity

ObjectiveThe effect of autologous fat filling combined with ligament release in patients with lacrimal groove defect was analyzed to provide a reference for clinical treatment.MethodsA total of 80 patients(160 patients)with lacrimal groove deformity were selected from June 2016 to January 2018 in our hospital.The selected groups were all accompanied by lacrimal groove deformity,and some patients may be accompanied by mild orbital septal hernia.The patients were randomly divided into two groups:group A:40 patients(a total of 80 patients)treated with nanofat,granular fat filling combined with lacrimal ligament release were used as the observation group.And set the control group as group B,40 patients(80 cases)treated with autologous fat filling.Each group was divided into 3 groups according to the preoperative Barton classification.In group A,the blunt needle was used to release the lacrimal ligament,and the autologous fat graft was injected into the depression of the lower eyelid.The nanofat 27G sharp needle was injected subcutaneously to correct the lacrimal groove deformity.In group B,large-grain fat was directly transplanted into the depressed area through a blunt needle to correct the tear groove deformity,and the autologous fat filling volume was 2ml to 3.5ml unilaterally.Followed up from 3 months to 12 months after operation.Observation and comparison between the two groups of AB,based on the degree of postoperative satisfaction of normal aesthetic effects,the effectiveness of skin improvement,and using the Barton grading system to measure the surface anatomy of lacrimal groove deformity and the evaluation of the incidence of complications.Statistical software SPSS 20.0 was used for data analysis.Results1,After 6 months of treatment,the satisfaction rate of group A(92.5%)was 37.5%higher than that of group B(55%),p=0.036<0.05(P<0.05),which was statistically different.The effective rate of skin improvement in group A(97.5%)was 17.5%higher than that in group B 80%,p=0.0006<0.05,which was statistically different.2,Barton graded curative effect score:There was no statistical difference between Group A and Group B on Barton I(P>0.05),and there were statistical differences on Barton Ⅱ and Ⅲ at 6 months after operation(p<0.05).3,The ratio of anatomical structure of lacrimal groove deformity:TTDH/PFW(%)and LEBH/PFW{%)in each group after surgery were significantly lower than those before surgery,and the difference was statistically significant(P<0.05).Postoperative TTDH/PFW(%):comparison,AI,A2,A3 group with B1,B2,B3 group,pairwise comparison between groups,there was no statistically significant difference between A1 group and B1 group(P<0.05),A2,A3 Groups were compared with groups B2 and B3,and there were significant differences between groups A2 and B2,A3 and B3(P<0.05).Postoperative LEBH/PFW(%):A1,A2,and A3 groups were compared with B1,B2,and B3 groups,and there was no significant difference between the two groups(P>0.05).4,Statistics of postoperative complications.Group A(7.5%)had edema,and the incidence of skin stasis was higher than that of group B(2.5%).In group B,4 cases(5%)showed local unevenness,and 3 cases(3.75%)were subcutaneous.Sclerosis,but none of the patients in group A;bulbar conjunctival edema in both patients in group AB,group A(1.25%was lower than group B(2.5%).All patients had no serious complications such as nerve injury and infection.in conclusion1,nanofat,granular fat filling combined with lacrimal groove ligament release to correct lacrimal groove deformity has a significant effect on skin improvement and is superior to the simple fat filling method,with high patient satisfaction.2,For patients with mild lacrimal groove deformity,nanofat,granular fat filling combined with lacrimal groove ligament release is not significantly different from simple fat filling.For the correction of moderate to severe lacrimal groove deformity,autologous fat filling combined with ligament release is more effective.3,nanofat,granular fat filling combined with lacrimal groove ligament release and autologous fat filling did not have much difference in correcting the bags under the eyes.4,This procedure does not increase the incidence of surgical complications,the incidence of lower eyelid eversion and subcutaneous induration,and the operation is maintained for a long time,it is worth promoting.