title: Internal cantholysis for repair of moderate and large full-thickness eyelid defects.
abstract: OBJECTIVE
  To determine the safety and efficacy of internal cantholysis for closure of larger full-thickness eyelid defects.
  
  
  METHODS
  Retrospective review of a consecutive case series.
  
  
  METHODS
  Eighteen patients (18 eyelids) underwent internal cantholysis for repair of a moderate or large full-thickness eyelid defect during the study period.
  
  
  METHODS
  Retrospective review of a consecutive case series of all patients undergoing transconjunctival lateral cantholysis for repair of moderate and large full-thickness eyelid defects between October 2008 and November 2010. Moderate was defined as ≥ 14 mm in horizontal length, and large was defined as ≥ 20 mm in horizontal length.
  
  
  METHODS
  Charts were reviewed for patient demographics; indication for surgery; defect size, type, and location; other concomitant repair; follow-up interval; and complications.
  
  
  RESULTS
  Eighteen patients (18 eyelids) underwent internal cantholysis for repair of a moderate or large full-thickness eyelid defect during the study period. Average patient age was 73 years (range, 45-94 years), and there were 10 male and 8 female patients. Average defect size was 19.0 mm (range, 14-25 mm). Average follow-up interval was 4.6 months (range, 1-12 months). Complications included eyelid margin notch (3 cases), persistent canthal dystopia (3 cases), trichiasis (2 cases), pyogenic granuloma (2 cases), eyelid margin nodule (1 case), lower eyelid elevation of 1 mm (1 case), and mild resolving medial lagophthalmos (1 case). No patient requested or required further surgery on the operated eyelid for any reason during the study period.
  
  
  CONCLUSIONS
  Internal cantholysis allows for closure of moderate and large full-thickness eyelid defects. Complications are acceptable in light of the morbidity of other therapeutic options, such as semicircular flap or shared eyelid flap procedures.
authors.affiliation: Division of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. perryj1@ccf.org
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
authors.forename: Milap P
authors.initials: MP
authors.lastname: Mehta
authors.forename: Craig D
authors.initials: CD
authors.lastname: Lewis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome