Lateral canthal surgery.
The lateral canthus is a delicate and complicated three-dimensional structure with function relevant to the health of the ocular surface. Dysfunction of the lateral canthus, due to aging changes or iatrogenic trauma, results in ocular morbidity ranging from chronic irritation to tearing to recalcitrant keratopathy. From an aesthetic standpoint, symmetric, normally positioned lateral canthi are cornerstones of youthful periorbital appearance, disruption of which leads to cosmetically significant deformity or asymmetry. Reconstruction of the lateral canthus is important in the rehabilitation of the aging eyelid and an unfortunate necessity after failed lateral canthal surgery. The common methods for improving or maintaining position, tone, and shape of the lower eyelid and lateral canthus use tightening or shortening the lower eyelid horizontally, keeping the canthal angle in an appropriate vertical level, and hugging the ocular surface. Many techniques have been described for the reconstruction of the lateral canthus in functional conditions or for aesthetic purposes. These methods have met with varying success. In this article, we begin with a discussion of the anatomy and physiology of the lateral canthus, followed by clinical examples of lateral canthal abnormalities and underlying pathophysiologies. A review of surgical options for the lateral canthus is presented with concluding remarks on postoperative complications.
Division of Orbital and Ophthalmic Plastic Reconstructive Surgery, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
Kelvin Kam-Lung
KK
Chong
Robert A
RA
Goldberg
D019882:Blepharoplasty / Q000379:methods*; D005141:Eyelid Diseases / Q000601:surgery*; D005143:Eyelids / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D017060:Patient Satisfaction; D016896:Treatment Outcome