A Novel Surgical Technique Involving Bone Fixation Canthoplasty, Middle Lamellar Recession, and Mucograft Spacer in...

Euryblepharon is a rare congenital eyelid malformation characterized by symmetrical horizontal enlargement of the palpebral fissure. The eyelid is shortened vertically compared with the horizontal dimension. The lateral canthus is most commonly affected. It can be isolated or associated with other anomalies and it is unclear what causes this appearance. Conservative treatment is the mainstay of treatment; however, in some severe cases, surgery is necessary. Surgery has been reported with varying degrees of success with failure of the resolution of the functional or cosmetic elements.

In a retrospective case review, 7 patients were identified with euryblepharon. Some had mild changes and were asymptomatic with no concerns regarding the appearance of their eyelids, while others suffered from ocular irritation and dry eyes and were bothered by the cosmesis. Three opted to go ahead with surgery as they found conservative measures to be unsatisfactory.

For those patients who opted for surgery, the authors performed lower eyelid bone fixation canthoplasty with septoretractor recession with or without a mucograft spacer. This technique corrected both their functional and cosmetic elements.

The success in normalizing the lower lid position and contour without skin augmentation suggests that the underlying pathology is related to middle lamellar retraction and lateral canthal dystopia rather than skin deficiency. This new technique corrects both the functional and aesthetic issues without compromising on either element which has been the case in previous studies. It is also tissue-sparing and can be done as a day-case procedure.