Chong Kelvin Kam-Lung, Goldberg Robert A
Division of Orbital and Ophthalmic Plastic Reconstructive Surgery, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
Facial Plast Surg. 2010 Aug;26(3):193-200. doi: 10.1055/s-0030-1254329. Epub 2010 Jun 3.
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.
外眦是一个精细复杂的三维结构，其功能与眼表健康相关。由于衰老变化或医源性创伤导致的外眦功能障碍，会引发从慢性刺激到流泪再到顽固性角膜病变等一系列眼部疾病。从美学角度来看，对称、位置正常的外眦是年轻眶周外观的基石，其破坏会导致明显的美容畸形或不对称。外眦重建在衰老眼睑的修复中很重要，也是外眦手术失败后无奈的必要措施。改善或维持下眼睑和外眦位置、张力及形状的常用方法是水平收紧或缩短下眼睑，使眦角保持在适当的垂直水平，并贴合眼表。已经描述了许多用于功能性或美学目的外眦重建的技术。这些方法取得了不同程度的成功。在本文中，我们首先讨论外眦的解剖学和生理学，接着是外眦异常及潜在病理生理学的临床实例。本文还对外眦手术选择进行了综述，并对术后并发症给出总结性评论。
