Connection of the orbital septum with surrounding structures and its histology in relation to mild ptosis in blepharoplasty patients
Objective To observe the connection of the orbital septum with surrounding structures and its histology in relation to mild ptosis in blepharoplasty patients.Methods From May 2018 to December 2019,276 patients(549 eyes)who underwent blepharo-plasty were divided into normal group and mild ptosis group according to the condition of upper eyelid,and the orbital septum was ob-served.The connection between the orbital septum and the surrounding structures,and the histologic structure of the orbital septum were observed.Results There were 498 eyes in the normal group and 51 eyes in the mild ptosis group.Comparing between the two groups,the incidence of adhesions between the orbital septum and the orbital lipid envelope was higher in the mild ptosis group(x2=95.00,P＜0.001),and the incidence of transverse ligament between the orbital septum and the levator aponeurosis was higher in the mild ptosis group(x2=99.00,P＜0.001).HE staining showed that the orbital septum in both groups was mainly a connective tissue structure that could be divided into two layers.The anterior layer was looser and the posterior layer was denser.In the mild ptosis group,the connective tissue fibers were less and looser than in the normal group.Masson staining showed that no muscular structures were found in the orbital septum of both groups.SMA staining showed that in the orbital septum of both groups,except for the blood vessels running through the orbital septum which were positive,the rest of the tissues stained negatively by SMA staining,and no smooth muscle structures were found in the orbital septum of both groups.Conclusion Adhesions between the orbital septum and the orbital lipid envelope and restrictive ligament between the orbital septum and the levator aponeurosis may be the cause of mild ptosis.
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