Postsurgical lateral canthal web correction using vertical Z-plasty combined with 5-fluorouracil (5-FU) injections

Area of Science:

• Ophthalmology
• Plastic Surgery
• Reconstructive Surgery

Background:

• Post-surgical lateral canthal webbing presents a reconstructive challenge.
• Previous surgeries can lead to significant scarring and vertical skin contraction, complicating treatment.

Purpose of the Study:

• To evaluate the surgical outcomes of lateral canthus reconstruction using vertical Z-plasty combined with canthoplasty and 5-fluorouracil (5-FU) injections.
• To assess the efficacy of this combined technique in correcting post-surgical lateral canthal webbing.

Main Methods:

• Retrospective review of 11 patients (17 eyelids) undergoing lateral canthal reconstruction.
• Surgical technique involved vertical Z-plasty, canthopexy/canthoplasty, and 5-FU injections.
• Follow-up period averaged 14 months (range 5-23 months).

Main Results:

• No intraoperative complications were reported.
• All cases demonstrated significant improvement in lateral canthal webbing.
• No recurrence of webbing was observed during the follow-up period.

Conclusions:

• Vertical Z-plasty combined with 5-FU injections is an effective method for correcting lateral canthal webbing with minimal scarring.
• This technique is particularly advantageous for patients with a history of multiple surgeries, significant scarring, or vertical skin contraction.
• The technique can be successfully combined with a periosteal flap for concurrent lower eyelid horizontal shortening correction.