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目的为提高睑袋成形术的效果，延长有效时间，从理论与实际观察探讨下睑袋的形成原因及病理改变，采取相应手术矫正；尝试综合提紧睑袋切除成形。方法在局麻下，沿下睑缘作切口并在外眦部向外下方延长约５ｍｍ，切口与外眦夹角约１３５°，皮下潜行剥离至骨性眶缘，形成皮瓣；在眶隔膜表面分离形成与皮瓣形态一致的眼轮匝肌瓣；如疝出的眶隔脂肪量较多，可适量切除，一般尽量将疝出的眶隔脂肪还纳复位，横纵向折叠缝合眶隔以增加张力；向外上方提紧眼轮匝肌瓣，据情适量楔形切除一块眼轮匝肌缝合以加强下睑的支撑力；最后嘱受术者睁眼向上看并大张嘴，在下睑张力最大的情况下切除多余的皮肤。结果本组共４５例，男性１０例，女性３５例，年龄３５～６７岁，随访２２例３个月至２年，除１例因眼轮匝肌切除过多而产生轻度下睑退缩外，其余均效果满意持久。结论综合提紧法睑袋矫治术，是针对下睑衰老机理及表现而进行的一种手术设计，可提高手术效果并延长有效时间
Objective To improve the effect of blepharoplasty, extend the effective time, from the theoretical and practical observation of lower eyelid pocket formation and pathological changes, to take appropriate surgical correction; try to tighten the eyelid pouch resection. Methods Under local anesthesia, incision was made along the lower eyelid margin and extended outwardly and outwardly in the outer part by about 5 mm. The included angle between incision and epistaxis was about 135 °. The skin flap was dissected to the orbital margin of the bony orbital margin to form a flap. Isolated and formed with the same shape of the flap orbicularis oculi muscle flap; such as hernia out of the orbital fat mass may be appropriate to remove, generally try to hernia out of orbital fat also accept the reduction of transverse and longitudinal folding suture to increase Tension; outwardly above the orbicularis oculi muscle flap, according to the right amount of wedge resection of an orbicularis oculi muscle suture to strengthen the support force of the lower eyelid; finally by the surgeon eyes open up and big mouth, the largest tension in the lower eyelid Remove excess skin case. Results The group of 45 cases, 10 males and 35 females, aged 35 to 67 years old, followed up 22 cases from 3 months to 2 years, except for 1 case of orbicularis oculi muscle resection caused by mild excessive lower eyelid retraction , The rest are satisfied with the lasting effect. Conclusions Tightening of the eyelid pouch is a surgical design aimed at the mechanism and performance of the lower eyelid, which can improve the operation effect and prolong the effective time