Lateral tarsotomy: a practical alternative to lateral canthotomy to increase orbital access

Area of Science:

• Ophthalmology
• Plastic Surgery
• Orbital Surgery

Background:

• Transconjunctival lower orbit approaches are common for avoiding facial scars.
• Lateral canthotomy is used for increased exposure but poses challenges in canthal tendon resuspension.
• Unaesthetic outcomes can result from difficulties in lateral canthal tendon repair.

Observation:

• A novel "lateral tarsotomy" technique involving a lateral tarsal incision was described.
• This approach aims to enhance lateral orbital access without performing a lateral canthotomy.
• Two patients with internal orbital wall trauma underwent repair using transconjunctival approach with lateral tarsotomy.

Findings:

• Excellent cosmetic results were achieved with no visible scarring or deformity at the tarsotomy site.
• No ectropion, entropion, or scleral show was observed postoperatively.
• Functional outcomes were satisfactory at 1-week, 1-month, and 3-month follow-ups.

Implications:

• Lateral tarsotomy presents a practical and effective alternative to lateral canthotomy for orbital access.
• This technique may reduce the risk of unaesthetic outcomes related to lateral canthal tendon repair.
• Further studies could explore the broader application of lateral tarsotomy in orbital reconstructive surgery.