Anatomic study of the lateral palpebral raphe and lateral palpebral ligament

The aim of this study is to elucidate anatomic detail of the lateral canthal area relating to lateral canthoplasty. Thirty-three hemifaces of 22 Korean adult fresh cadavers were used. Thirty-one specimens were used for tension measurement and 2 for histologic study. There were 3 components of the lateral canthal area under the skin; lateral palpebral raphe (LPR), superficial lateral palpebral ligament (SLPL), and deep lateral palpebral ligament (DLPL). Lateral ends of superior and inferior orbicularis oculi muscles interlaced at the lateral commissure and formed LPR. SLPL extended from the lateral ends of tarsal plate to the periosteum of lateral orbital rim. Its transverse length was 9.4 +/- 2.6 mm and vertical width was 3.6 +/- 1.3 mm. DLPL extended from the lateral ends of tarsal plate deep to the origin of SLPL to Whitnall's tubercle on zygomatic bone inside the orbital margin. It is located deeper than SLPL. Its transverse length was 7.3 +/- 1.6 mm and its vertical width was 9.0 +/- 1.6 mm. Tensile strength of DLPL was 73.2 +/- 26.8 N and stronger significantly than SLPL (30.0 +/- 17.3 N). Tensile strength of LPR was 12.2 +/- 8.0 N and weaker significantly than SLPL and DLPL. A detailed understanding of 3 layered structures (LPR, SLPL, and DLPL) at lateral canthal area is conducive to performing lateral canthoplasty.