Lessa Sergio, Nanci Marcelo
Oculo-Plastic Surgery Department of the 1st Infirmary of the Santa Casa da Misericórdia do Rio de Janeiro-Ophthalmology Service, Rio de Janeiro, Brazil.
Ophthalmic Plast Reconstr Surg. 2009 Jul-Aug;25(4):284-8. doi: 10.1097/IOP.0b013e3181aa9426.
To describe a canthopexy technique without canthotomy that avoids release of the lateral canthal tendon for treatment of moderate lower eyelid laxity.
A total of 316 patients underwent canthoplasty-blepharoplasty between December 1996 and November 2007. None of the patients had previously undergone any aesthetic surgical procedure. All cases showed moderate laxity of the inferior eyelid, and in 22 cases (7%), there was antimongoloid obliquity of several degrees. The lateral canthal ligament was attached to the periosteum of the orbital rim with nonabsorbable suturing material through the upper blepharoplasty wound. This technique follows the principle of canthopexy without canthotomy, avoiding the dissection of a submuscular tunnel and the release of the lateral canthal tendon.
Lower eyelid laxity was corrected in all cases. During the first 2 weeks, a greater tension of the lower eyelid and a slight upward slanting of the lateral canthus were observed. During this period, palpebral movement was slightly limited. In the third week after surgery, eyelid shape and canthal positioning had become completely normal.
The technique described in this report greatly reduced surgical time and drastically lowered morbidity. It may be used in moderate lower eyelid laxity correction and in correction of moderate alterations of antimongoloid obliquity.
描述一种无需外眦切开术的眦固定技术，该技术避免松解外眦韧带以治疗中度下睑松弛。
1996年12月至2007年11月期间，共有316例患者接受了眦成形术 - 眼睑成形术。所有患者此前均未接受过任何美容外科手术。所有病例均表现为中度下睑松弛，其中22例（7%）存在数度的反蒙古样倾斜。通过上睑成形术切口，使用不可吸收缝合材料将外眦韧带附着于眶缘骨膜。该技术遵循无需外眦切开术的眦固定原则，避免了肌下隧道的分离和外眦韧带的松解。
所有病例的下睑松弛均得到矫正。在术后前2周，观察到下睑张力增加，外眦略有向上倾斜。在此期间，眼睑活动略有受限。术后第3周，眼睑形状和眦部定位已完全恢复正常。
本报告中描述的技术大大缩短了手术时间，并显著降低了发病率。它可用于中度下睑松弛的矫正以及中度反蒙古样倾斜改变的矫正。
