Lateral canthoplasty using the Mitek anchor system

Lower-eyelid shape and position have important aesthetic and functional implications. While primary canthoplasty is generally a straightforward procedure, secondary canthoplasty can be considerably challenging. This is especially true in the setting of poor periorbital tissues and the resultant lack of a stable platform from which to suspend the canthus. We report the first use of the Mitek device in secondary lateral canthal procedures to remedy this common problem.

Twelve patients underwent a total of 19 revision lateral canthoplasties using the mini Mitek suture anchor system. All of the patients had had prior cosmetic and/or reconstructive surgery in the lateral canthal area with resultant canthal malpositioning. To correct this, suture anchors were placed into a 2-mm area of intact bone on the lateral orbital wall, and the lateral canthal tendon was resuspended into proper position.

In this series, there were no postoperative infections or patient reports of persistent discomfort at the anchor sites. All suture anchors remained in proper position postoperatively, and patients reported satisfaction with eyelid shape and function. Most of the patients reported resolution of their preoperative symptoms. Mean follow-up time was 24.2 months.

The Mitek suture anchor is an excellent tool for lateral canthoplasty in patients with significant periorbital scarring or suboptimal canthal positioning after multiple cosmetic surgery procedures. It is also a good option for patients with significant soft tissue damage owing to prior surgery, radiation, or trauma in the periorbital field. This technique can be performed quickly through small incisions and requires only a small amount of stable bone for tendon fixation. Results are excellent and the procedure has proven to be safe and effective in our series of patients.