Surgical preferences for lateral canthoplasty and canthopexy

To describe the currently used techniques of lateral canthal tightening and their indications.

The treatment of involutional ectropion involves horizontal tightening of the lower eyelid via a lateral canthal resuspension procedure, which can be either a canthopexy or a canthoplasty. The lateral tarsal strip, one of the most common canthoplasty procedures performed today, is a powerful technique, very useful in cases of profound eyelid laxity or ectropion in which horizontal eyelid shortening is necessary to achieve adequate eyelid tightening.For less-severe eyelid laxity, a canthopexy can be performed through either an upper or a lower eyelid incision, in which the suture is passed through the eyelid incision without externalization at the lateral canthal angle. We recently described the lateral canthal resuspension sine canthotomy technique that was slightly more effective than the lateral tarsal strip at decreasing the MRD-2 and lengthened the horizontal palpebral aperture without significantly changing the lateral canthal height.

Although the lateral canthal resuspension sine canthotomy technique has advantages for tightening loose lower eyelids in both cosmetic and functional cases, the lateral tarsal strip remains the procedure of choice for severe lid laxity or ectropion.