Абстракт

Objectives: This study was performed to introduce a novel approach for transconjunctival fat repositioning using a bi-directional surgical needle. The advantages of this technique compared to conventional internal fixation (IF) and external percutaneous suture (EPS) techniques were discussed, and the effectiveness of this method in achieving satisfactory results with decreased downtime for patients undergoing tear trough deformity correction was also evaluated. Introduction: Lower eyelid contour changes result from prolapse of orbital fat and descent of cheek tissues, leading to accentuation of the orbital rim and tear trough groove. In such cases, it is advantageous to reposition the fat over the orbital rim, rather than removing it. For fixation of fat pedicle, the IF and EPS techniques are used, which have their own advantages and disadvantages. The present study aimed to introduce a novel approach of IF technique using a bi-directional surgical needle for specializing a transconjunctival fat repositioning and to compare its outcomes with conventional methods. Materials / method: Patients with primary tear trough deformity who underwent transconjunctival fat repositioning by IF were reviewed retrospectively. The new IF technique using devised bi-directional surgical needle for specializing a transconjunctival fat repositioning was adopted. Post-operative complications and aesthetic outcomes were assessed using a four-scale grading system. Results: A total of 32 patients was evaluated with a median follow-up of 90 days. In the analysis of aesthetic outcomes, all patients were grade 0 (no deformity) or I (mild deformity) post-operatively with scale scores improving by at least one grade. Procedure had a shorter mean operation time than conventional IF technique and shorter downtime than EPS techniques. 2 out of 30 patients underwent secondary operation due to under-correction, after which both had satisfactory results. There were no cases of ectropion, scleral show greater than 1 mm, dry eye, or vision loss. Patient satisfaction was high. Conclusion: Our technique using bi-directional surgical needle for specializing a transconjunctival fat repositioning might possess advantages of the conventional IF and EPS techniques, showing lower complication rates and aesthetically satisfactory outcomes with decreased down time, and could be a safe and reliable method of transconjunctival fat repositioning.