title: Centurion syndrome: clinical presentation and surgical outcome.
abstract: OBJECTIVE
  To describe the clinical signs and outcome of surgery in cases with Centurion syndrome and highlight the clinical presentation of this syndrome.
  
  
  METHODS
  A retrospective review of records of patients with Centurion syndrome who underwent surgery between January 2002 and July 2007. The position of the punctum, nasal bridge prominence, Hertel exophthalmometry and the presence of inferiorly directed sharp angulation of the medial canthus was noted. The patients underwent anterior canthal tendon release, punctoplasty or medial conjunctivoplasty or a combination of these.
  
  
  RESULTS
  Of the 13 cases, 10 had been treated medically elsewhere. The mean age of onset was 20.7 years. Most of the patients were male 10 (76.9%). A prominent nasal bridge was demonstrable in 9 (69.2%) patients and sharp inferior angulation of the medial canthus, the 'beak' sign was present in 9 (69.2%) cases. Anterior canthal tendon release alone was performed in 4 patients, in combination with punctoplasty in 5 and with conjunctivoplasty in 4. Watering resolved in 10 patients. 3 patients who had a combination of anterior canthal tendon release and punctoplasty had persistent but asymptomatic epiphora.
  
  
  CONCLUSIONS
  Centurion syndrome is characterised by the abnormal anterior insertion of the medial canthal tendon with displacement of the punctum out of the lacrimal lake. Most cases present with unexplained watering. Surgical management by anterior canthal tendon release with or without conjunctivoplasty or lower lid retractor plication is usually successful.
authors.affiliation: Oculoplasty and Ocular Oncology Service and Strabismus and Pediatric Ophthalmology Service, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Murthy
authors.forename: Santosh G
authors.initials: SG
authors.lastname: Honavar
authors.forename: Milind
authors.initials: M
authors.lastname: Naik
authors.forename: Vikas
authors.initials: V
authors.lastname: Menon
authors.forename: Anirban
authors.initials: A
authors.lastname: Bhaduri
authors.forename: Sima
authors.initials: S
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery*; D008297:Male; D013577:Syndrome; D055815:Young Adult