Aesthetic Lateral Canthoplasty Using Tarso-Conjunctival Advancement Technique

Abstract

Reduced horizontal length of the palpebral fissure is a distinctive characteristic of Asian eyelids, and aesthetic lateral canthal lengthening techniques have been performed for a refinement. The aim of this study is to describe a novel lateral canthoplasty using tarso-conjunctival advancement with a lid margin splitting procedure on the upper eyelids and to report the postoperative results. From December 2011 to June 2014, patients who underwent lateral canthoplasty using the tarso-conjunctival advancement procedure for aesthetic purposes were reviewed retrospectively. The predictor variables were grouped into demographic and operative categories. The primary outcome variables were the distances from the mid-pupillary line to the lateral canthus and the horizontal length of the palpebral aperture (distance from the medial to lateral canthus). Data analyses were performed using descriptive and univariate statistics. Patients who showed increment in objective measurements were considered significant. Aesthetic appearance was also evaluated based on pre- and postoperative clinical photographs. A total of 45 patients were enrolled in this study. Both the distance from the mid-pupil to the lateral canthus (ΔDpupil-lateral; 2.78 ± 0.54 mm, P <0.05) and the palpebral aperture horizontal length (ΔDmedial-lateral 2.93 ± 0.81 mm, P <0.05) increased significantly from pre- to postoperative state. All the patients demonstrated satisfactory results aesthetically during the follow-up. The tarso-conjunctival advancement technique for lateral canthoplasty produced satisfactory aesthetic results with an enlarged palpebral aperture. Future research is required to fully delineate the risk of possible complications, including injury to the eyelashes and meibomian glands.