New Findings in Prominent Lower Eyelid Fat Pads Possibly Contributing to Their Etiology: Two Prospective Studies.

IF 1.5 Q3 SURGERY Plastic and Reconstructive Surgery Global Open Pub Date : 2024-11-22 eCollection Date: 2024-11-01 DOI:10.1097/GOX.0000000000006340

Iliana E Sweis, Bryan C Cressey

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Abstract

Background: Little is known about the actual composition of prominent orbital fat pads. It was incidentally noted that hyaluronidase injections in prominent lower eyelid fat pads attenuated them, suggesting prevalence of hyaluronic acid (HA), and raising questions regarding their etiology. This led to 2 institutional review board studies: The first quantified HA concentration in orbital fat pads and assessed possible correlation between HA levels and degree of lower eyelid puffiness. The second determined if regular hyaluronidase injections in prominent lower eyelid fat pads impacted their size to uncover a possible role of intrinsic HA and its hydrophilic properties in their etiology.

Methods: Lower eyelid orbital fat harvested from 20 filler-naive blepharoplasty patients underwent enzyme linked immunosorbent assay for HA quantification. A separate group of 14 filler-naive patients requesting nonsurgical treatment of lower eyelid puffiness were treated with a series of hyaluronidase injections.

Results: HA levels in prominent eyelid orbital fat pads averaged 39.3 µg/mg of the dry weight, higher than reported in other solid human tissues. Orbital fat HA levels correlated with the degree of clinical puffiness. Hyaluronidase attenuated lower eyelid puffiness in 78.6% of patients. The extent and duration of improvement varied between responders but increased with repetitive injections.

Conclusions: Prominent orbital fat pads have a higher HA concentration than reported in other solid human tissues. HA hydrophilic properties likely contribute to fat pad edema manifesting as puffiness. Attenuation of prominent lower eyelid fat pads following hyaluronidase injections further implicates intrinsic HA in the etiology of prominent eyelid fat pads.

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下眼睑脂肪垫突出的新发现可能是其病因之一：两项前瞻性研究。

背景：人们对突出眼眶脂肪垫的实际组成知之甚少。人们偶然发现，在突出的下眼睑脂肪垫注射透明质酸酶后，脂肪垫会缩小，这表明透明质酸（HA）普遍存在，并提出了有关其病因的问题。因此，机构审查委员会进行了两项研究：第一项研究量化了眼眶脂肪垫中的透明质酸浓度，并评估了透明质酸水平与下眼睑浮肿程度之间可能存在的相关性。第二项研究确定在突出的下眼睑脂肪垫中定期注射透明质酸酶是否会影响其大小，以揭示内在 HA 及其亲水性在其病因中可能扮演的角色：方法：从 20 名无填充物的眼睑成形术患者身上采集的下眼睑眶脂肪进行了酶联免疫吸附试验，以确定 HA 的数量。另外对 14 名要求非手术治疗下眼睑浮肿的无填充物患者进行了一系列透明质酸酶注射治疗：结果：突出眼睑眶脂肪垫中的 HA 含量平均为 39.3 µg/mg 干重，高于其他固体人体组织中的含量。眼眶脂肪 HA 含量与临床浮肿程度相关。78.6%的患者的下眼睑浮肿有所减轻。不同患者的改善程度和持续时间各不相同，但随着重复注射，改善程度和持续时间会增加：结论：与其他固体人体组织相比，突出的眼眶脂肪垫具有更高的 HA 浓度。HA的亲水性可能会导致脂肪垫水肿，表现为浮肿。注射透明质酸酶后，突出的下眼睑脂肪垫会减弱，这进一步说明内在的 HA 与突出的眼睑脂肪垫的病因有关。

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来源期刊

Plastic and Reconstructive Surgery Global Open SURGERY-

CiteScore

2.20

自引率

13.30%

发文量

1584

审稿时长

10 weeks

期刊介绍： Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.