Clinical Retrospective Analysis Of Dissatisfied Double Eyelid Associated With Blepharoptosis

Background and ObjectiveDouble eyelid blepharoplasty is a common clinical operation in plastic surgery.Postoperative complications often occur due to preoperative design defects and improper surgical operations or other reasons.As one of the postoperative complications,blepharoptosis seriously affects the aesthetics and function of the eyelid.We analysis the clinical characteristics,the previous treatment methods of patients,the corresponding repair methods and the postoperative effects.It aims to provide prevention and solutions for clinical practice.MethodSubjects:44 patients(74 lateral eyes)who underwent blepharoptosis correction surgery after double eyelid related surgery in plastic surgery at the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2019.We analyze and summarize the previous operation time,operation method and the cause of postoperative ptosis.According to the severity of ptosis and levator muscle strength,we choose the corresponding surgical repair method,and select the corneal exposure rate,MRD,double eyelid width and patients' satisfaction for postoperative effects.Then we extract data for statistical analysis to evaluate the effectiveness of repair surgery.Results1.The previous surgery methods of 44 cases(74 lateral eyes)of blepharoptosis after double eyelid-related surgery:22 cases of incision method,3 cases of suture method,19 cases of ptosis correction.The average corneal exposure rate was 64.45%±8.34%.the average MRD was 1.35±0.08mm.The average double eyelid width was 7.59±0.19mm(7mm?10mm).The average levator muscle strength was 6.03 ±0.34mm(1mm?10mm).2.Analysis of the causes of the cases:21 sides(28.4%)of the affected eye with ptosis before surgery,the eyelid line was designed to be wider on 7 sides(9.5%),and the suture site was too high on 8 sides(10.8%).Extensive adhesion on 24 sides(32.4%),intraoperative injury of the levator aponeurosis on 4 sides(5.4%),postoperative hematoma on 2 sides(2.7%),and postoperative recurrence on 8 sides(10.8%).).There were 46 eyes(62.2%)with mild eyes,15 eyes(20.3%)with moderate eyes,and 13 eyes(17.6%)with severe eyes.3.Surgical repairt method:11 sides(14.9%)with levator fold correction method,4 sides(5.4%)with levator shortening method,7 sides(9.5%)by CFS+LM method,6 sides(8.1%)with suture removal,17 sides(23.0%)with fat flap transfer,18 sides(24.3%)with autologous fat transplantation,and 4 sides(5.4%)with levator aponeurosis repair.4.The everage corneal exposure rate was 89.52%±4.09%after surgery,the average increase in expose rate was 25.07%±6.72%,the everage MRD was 3.98±0.04mm,the average increase in MRD was 2.63±0.06mm,the width of double eyelid was 6.97±0.12mm(6mm?9mm),and patients'satisfaction rate was 95.5%.Comparing the corneal exposure rate and MRD before and after operation,the difference was statistically significant(P<0.05).Conclusions1.There are many causes of blepharoptosis after double eyelid related surgery,but there main causes are different degrees of ptosis before surgery and high adhesion of skin with aponeurosis.2.For the treatment of ptosis after double eyelid related surgery,corresponding repair methods should be used for different reasons,and the levator muscle strength of the upper eyelid should be paid attention to.3.In order to reduce the occurrence of blepharoptosis after double eyelid related surgery,detailed preoperative evaluation and design,and careful surgical operation are very important.