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Abstract：
Background: Conjunctival chemosis, a complication of lower blepharoplasty, can cause persistent discomfort and functional disturbances with worsening in the postoperative period following surgery. Methods: A review of the records of the lower blepharoplasty procedures carried out at the Humanitas Research Hospital, Rozzano, Milan, Italy was performed. Patients were categorized into two groups depending on the procedure performed: (1) transconjunctival blepharoplasty with the removal of the fatty lodges with canthopexy and (2) transcutaneous blepharoplasty with the removal of the fatty lodges with lateral canthoplasty. Each group was further divided into two more groups based on the surgical method used, that is either (a) cold blade and disposable cautery or (b) radiofrequency cut and coagulation and colorado tip (respectively 1a, 1b, 2a and 2b). All patients underwent a postoperative follow-up up to 24 months, which included an evaluation of cosmetic appearance, eyelid scarring and the severity of chemosis. The aim of the study was to investigate which of the surgical procedures causes a lower incidence of persistent type 3 conjunctival chemosis. Results: A total of 1047 patients who underwent lower lid blepharoplasty were included in the study. A total of 512 patients underwent transcutaneous blepharoplasty and 535 underwent the transconjunctival procedure. Among the first group of patients, 266 belong to group 1a and 246 to group 1b. In the second group, 264 were categorized as group 2a and 271 as group 2b. The incidence of type 3 chemosis in the transcutaneous blepharoplasty procedure with lateral canthoplasty was statistically significantly higher than in the transconjunctival approach, considering both the cold blade and the radiofrequency (p = 0.012, 0.010, 0.006, 0.004, respectively). Conclusions: A higher incidence of persistent type 3 conjunctival chemosis is associated with lateral canthus surgery and with the use of radiofrequency.
摘要：
背景：结膜化学，下睑成形术的并发症，可引起持续的不适和功能障碍，并在术后期间恶化。方法：回顾在Humanitas研究医院进行的下睑成形术的记录，罗扎诺,米兰,意大利演出。根据所执行的程序，将患者分为两组：（1）经结膜眼睑成形术，并通过canthopexy去除脂肪壁；（2）经皮眼睑成形术，并通过侧角成形术去除脂肪壁。根据所采用的手术方法,每组又分为两组,即(a)冷刀片和一次性烧灼器或(b)射频切割和凝固和科罗拉多尖端(分别为1a，1b,2a和2b)。所有患者术后随访24个月,其中包括对外观的评估，眼睑疤痕和化学的严重程度。该研究的目的是调查哪种外科手术导致持续性3型结膜化学病的发生率较低。结果：共有1047例接受下眼睑成形术的患者被纳入研究。共有512例患者接受了经皮眼睑成形术，535例接受了经结膜手术。在第一组患者中，266属于1a组，246属于1b组。在第二组中,264人被归类为2a组，271人被归类为2b组。经皮睑成形术与经侧角成形术的3型化学病的发生率在统计学上明显高于经结膜入路，同时考虑冷叶片和射频（p=0.012，0.010，0.006，0.004，分别）。结论：持续性3型结膜化学病的发生率较高，与侧角手术和射频的使用有关。
