The absent lateral canthal tendon: reconstruction using a Y graft of palmaris longus tendon

Absence of the lateral canthal tendon, whether congenital or acquired, imposes cosmetic and functional deformities that are surgically correctable. We propose a means of reconstructing the lateral canthal tendon using a Y graft of palmaris longus tendon. The benefits of this method are discussed. We believe it offers an alternative approach for supporting the lateral canthus and lower eyelid, and is especially useful when reestablishment of the lateral canthal tendon is necessary because of local tissue destruction or congenital absence. Three patients with congenital absence of the lateral canthal tendon are presented.