Erschienen in:
The American Journal of Cosmetic Surgery, 18 (2001) 1, Seite 21-30
Sprache:
Englisch
DOI:
10.1177/074880680101800104
ISSN:
0748-8068;
2374-7722
Entstehung:
Anmerkungen:
Beschreibung:
Purpose: To describe a small-incision approach to eyelid laxity repair employing a short, periosteal flap canthopexy to be used in association with aesthetic eyelid procedures. Methods: Cadaver specimens were used for surgical dissection to demonstrate the relevant anatomy and technique. Histologic sections through the lateral orbit were examined to identify the lateral canthal anatomy. Patients with ≥2 + lateral canthal ligament laxity, lateral canthal dystopia or rounding, a lower eyelid distraction measurement of ≥6 mm, or frank or incipient ectropion were selected for the procedure. Clinical records, including preoperative and postoperative photographs, were retrospectively reviewed to evaluate the surgical outcome. Results: One hundred fifty-six eyelids met inclusion criteria for small-incision eyelid laxity repair. Thirty-six procedures were performed for ectropion or lower lid laxity alone. The remaining 120 were performed in association with other eyelid or facial procedures. Sixteen included adjunct upper lid blepharoplasty. Six eyelids were tightened in combination with both upper and lower blepharoplasty. Forty-eight lid repairs were combined with upper lid blepharoplasty and ptosis repair. Twenty-eight lid procedures included ptosis repair alone. Twenty-two lower lid laxity repairs were combined with other procedures. Average follow-up was 58 days. Lower lid and canthal angle positions were symmetric with improvement in laxity, contour, and apposition to the globe in all cases. No reoperations were required. Conclusions: A novel canthopexy technique for eyelid laxity repair is described. This new technique offers significant advantages. Aesthetically, the incision is well hidden, and the canthal angle is preserved, allowing for improved cosmesis. Anatomically, the periosteal flap raised inside the orbital rim correctly restores lid-to-globe apposition and allows a secure bite through the periosteum. It allows for greater technical ease in securing the eyelid tissues within the orbital rim and in adjusting the final tension and height.