Eye Measurements and Application of Medial Canthoplasty and Lateral Canthoplasty

 

Let us take a look at surgical techniques applicable to cases shown in Figures 2 and 3.

Case 1: The nasal scleral triangle is relatively smaller and eyes seem wide apart (Figure 4)

Medial canthoplasty alone can bring drastic improvement.

Figure 4.The nasal scleral triangle is relatively smaller and eyes seem wide apart

 

Case 2: A relatively small lateral scleral triangle (Figure 5) can be corrected with lateral canthoplasty.

Figure 5. A relatively small lateral scleral triangle can be corrected with lateral canthoplasty

 

Case 3: When both the nasal and lateral scleral triangles are small (Figure 6), medial canthoplasty and lateral canthoplasty are carried out simultaneously.

Figure 6. When both the nasal and lateral scleral triangles are small, medial canthoplasty and lateral canthoplasty are carried out simultaneously.

 

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Not all patients fall into these basic categories. In lateral canthoplasty, there is often the problem of space limited by the orbital bone. And in medial canthoplasty, it is better to make a forward opening slightly smaller than the ideal ratio, if the caruncle is too noticeable. It is undesirable for the caruncle to be excessively exposed.

Patients tend to believe that medial canthoplasty will make the eyes appear closer together whereas lateral canthoplasty will make the eyes appear farther apart. However, this is a misconception.

For example, as shown in Figure 7, the eyes appear far apart due to wide-set orbits. In this case, medial canthoplasty will not change the positioning of the pupils. Aggressive medial canthoplasty can even make the eyes appear farther apart.

 

Figure 7. Eyes with wide-set orbits.

 

Figure 8. Eyes with close-set orbits.

 

-To be continued