The relationship of capsulopalpebral fascia with orbital septum of the lower eyelid: an anatomic study under magnification.

The aim of this study is to elucidate each insertion of the capsulopalpebral fascia (CPF) and orbital septum (OS) in the lower eyelid. Fifteen eyelid specimens were obtained from 15 Korean male adult cadavers for the study. Three parasagittal sections were made apart at medial limbus, midpupillary line and lateral limbus. The specimens were cut in 10-mum sections, stained with Masson-trichrome and observed under light microscopy. The head of the CPF split open superiorly and inferiorly wrapping around the inferior oblique muscle and met anteriorly. CPF inserted to the inferior border of the tarsus, merging the anterior border of the inferior tarsal muscles. OS blended with CPF most closely at 3.7-5.4 mm beneath the lower tarsal border: and differently at 3.7 +/- 0.7 mm on the medial limbus line, 4.3 +/- 0.8 mm on the midpupillary line and 5.4 +/- 1.0 mm on the lateral limbus line. The blending level is closer to the tarsus at the medial side than the lateral side. The closest distance between the lower tarsal border and the first identifiable smooth muscle nuclei of the inferior tarsal muscle was 2.1-2.7 mm, and differently 2.7 +/- 0.7 mm on the medial limbus line, 2.7 +/- 0.7 mm on the midpupillary line and 2.1 +/- 0.9 mm on the lateral limbus line. Precise anatomical understanding of OS and CPF may be conducive to the lower eyelid surgery.