Posterior Medial Canthal Thermoplasty

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Techniques

Background:

• Medial canthal tendon laxity can lead to eyelid malposition such as ectropion and entropion.
• Existing surgical techniques may be invasive or complex.
• A simple, minimally invasive approach is needed for effective management.

Purpose of the Study:

• To describe a novel, straightforward, and minimally invasive surgical technique for addressing medial canthal tendon laxity.
• To evaluate the efficacy and safety of this new procedure.

Main Methods:

• A retrospective review of 55 patients (59 procedures) undergoing posterior medial canthal thermoplasty.
• The technique involves creating a posterior lamellar scar with sutures preplaced in medial canthal tissue and a diathermy burn, followed by horizontal plication.
• This was performed in conjunction with standard surgery for eyelid malposition.

Main Results:

• The study included 55 patients (mean age 77 years), with epiphora and ocular irritation as common complaints.
• Indications included lower eyelid ectropion (51%) and entropion (44%).
• 90% of patients experienced complete symptom resolution, 83% had successful correction of medial canthal tendon laxity, and 96.6% achieved normal eyelid margin position with no major complications.

Conclusions:

• Posterior medial canthal thermoplasty is a simple, effective, and safe surgical option.
• The technique demonstrates high success rates in correcting medial canthal tendon laxity and associated eyelid malpositions.
• This procedure offers a valuable addition to the management of medial canthal tendon laxity.