An Integrated Lateral Canthoplasty for Simultaneous Lateral and Vertical Palpebral Fissure Enlargement

Abstract Background Cosmetic lateral canthoplasty and cosmetic vertical enlargement of the palpebral aperture have been reported, one performed after the other, to enlarge palpebral fissures in East Asia. However, 2 separate operations are required to achieve this objective. Objectives Here, we introduce a new lateral canthoplasty technique for the simultaneous lateral and vertical enlargement of the palpebral fissure. Methods Records of patients who underwent the new lateral canthoplasty from February of 2018 to February of 2023 were reviewed. Images were collected and imported with Image-Pro Plus 6 software. Four measurements were included: (1) the distance from the midpupillary line to the lateral canthus; (2) the inclination between the medial canthus and lateral canthus; (3) the distance from the pupil midpoint to the lower eyelid margin; (4) the distance from the pupil midpoint to the lower eyelid margin at the lateral limbus margin. The satisfaction rates and complications were also analyzed. Results Six months after surgery, the distances from the midpupillary line to the lateral canthus, from the pupil midpoint to the lower eyelid margin, and from the pupil midpoint to the lower eyelid margin at the lateral limbus margin were significantly increased (P < .05). The inclination between the medial and lateral canthus significantly decreased. No severe complications occurred. Conclusions The new lateral canthoplasty is an effective and stable technique, with natural-looking results and fewer complications, for simultaneously extending the length of the palpebral fissure, decreasing the inclination between the medial and lateral canthus, and enlarging the vertical distance of the palpebral aperture. Level of Evidence: 4 (Therapeutic)