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M. Goisis, M. Guareschi, R. Angeli, S. Miglior; Medial Canthoplasty Aproach for the Management of Acquired Epiphora . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3782.
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A new operation to correct lower eyelid laxity and acquired epiphora was evaluated.
A new V–Y, medial approach to lachrymal sac was performed on six orbits of three cadavers. The procedure was also performed on 14 eyelids of 12 patients with lower eyelid medial ectropion in conjunction with acquired ephiphora due to lacimal sac obstruction. The "V" shape incision was made along the lid margins from the puncta to the inner canthus, and the skin undermined to expose the orbicularis muscle. Then, the muscle was opened to explore the periosteum and to do a conventional external dacryocystorhinostomy. At the end of the procedure, one adsorbable suture was passed from the orbicularis muscle above the upper caniliculus to the muscle below the lower canaliculus. This suture was then tied to close the inner canthus medial to the lacrimal punctum and to invert the punctum. Then, the "V" shape skin incision was closed with a "Y" shape.
The mean follow up period was 11 (SD 9.3) months (range 2–26). Both functional recovery and cosmetic outcome were excellent. Improved postoperative eyelid position was found in all of the patients. There was no recurrence of epiphora
This procedure appears to be a safe, reproducible, and effective corrective procedure for lower eyelid medial ectropion in conjunction with acquired epiphora. In fact, it provides a wide exposure and a safe access to the lacrimal fossa. Furthermore, it corrects the malposition of the medial lower eyelid.
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