Transconjunctival Lowering of the Lateral Lower Eyelid by Shortening of the Posterior Lamellae

ABSTRACT

Commonly, the lateral canthus is located higher than medial canthus and many people are often shown short lateral palpebral fissure. This seemed to be shown as wild, anxious, and pierced eye. Many surgeons have made desperate efforts to improve this by anchoring lateral canthus to lower part of orbital bone. But, authors would like to show the two-third portion of the lateral lower eyelid by anchoring to capsulopalpebral fascia via transconjunctival approach. Authors performed this operation since 2009 and first named it by "Nun-Mit-Teuim" in Korean. Key of this operation is that anchoring of the lower tarsus and capsulopalpebral fascia via transconjunctival approach without resection of skin. It is not necessary to remove a redundant conjunctiva. Commonly, the lateral canthoplasty is performed simultaneously to descend a lower eyelid easily. After the operation, it can be observed that the lower eyelid lift up a little bit for 1~2 weeks and redundant conjunctiva will be constricted in several months. The operation is defined as anchoring the lower tarsus to capsulopalpebral fascia. The limit of the operation is it cannot change the position of the lateral canthus. Over-lowering the lower eyelid to increase palpebral fissure, results in scleral show and unfavorable line. Thus, it is important that surgeons should remind the purpose and limitation of this operation.