The role of the lateral canthal tendon in lower eyelid laxity

Measurements of lower eyelid length were completed to determine if the length of the lower eyelid increased with advancing age. The results support the that the lower eyelid indeed does not get longer with aging. In two groups of 100 patients each, at either end of the adult age spectrum, there were no statistical differences in the lengths of the lower eyelids. Our data support the concept that the lateral canthal tendon stretches with advancing age and allows the lateral canthus to drift medially, thus allowing for shortening of the horizontal palpebral fissure and contributing to the marked laxity of the lower eyelids often seen in older individuals. More attention should be paid to this etiologic factor in the surgical correction of lower eyelid laxity.