Postsurgical lateral canthal web correction using vertical Z-plasty combined with 5-fluorouracil (5-FU) injections.

PURPOSE

To evaluate the surgical outcomes of lateral canthus reconstruction using vertical Z-plasty combined with canthoplasty and 5-fluorouracil (5-FU) injections in patients with post-surgical lateral canthal webbing.

METHODS

A retrospective review was conducted on 11 patients (17 eyelids) who underwent lateral canthal reconstruction between 2021 and 2024 due to post-surgical lateral canthal webbing. The technique involved vertical Z-plasty combined with canthopexy or canthoplasty, along with 5-FU injections in all cases.

RESULTS

No intraoperative complications were reported. During the follow-up period (mean 14 months; range 5-23 months), all cases showed significant improvement in lateral canthal webbing with no recurrence observed.

CONCLUSION

The Z-plasty technique effectively corrected lateral canthal webbing without significant scarring. This method is particularly beneficial in patients with prior multiple surgeries, significant scarring, and vertical skin contraction. In cases with concurrent horizontal eyelid shortening, the technique was successfully combined with a periosteal flap to restore lower eyelid length.