Researchers created a standardized evaluation to determine the appropriate lateral canthal and ancillary procedures to perform for lower eyelid deformities or in patients at risk for postoperative lower eyelid malposition.
Senior authors Elizabeth B. Jelks, MD, and Glenn W. Jelks, MD, performed 146 consecutive lower eyelid canthal procedures that met study inclusion criteria.
Researchers documented vector analysis, lid margin eversion, lid snap-back and distraction test, scleral show, canthal tilt and lateral canthus-to-orbital rim soft-tissue distance for all patients with a postoperative follow-up of 5 years.
For the majority of cases (62%), vector analysis was negative. Preoperative lid margin eversion was grade 0 (no deformity) in 88% of cases, and most patients (79%) had no scleral show.
Canthal tilt ranged from +3 mm to –3 mm with a positive canthal tilt in 33% of cases, neutral canthal tilt in 49% and a negative tilt in 18%.
Lateral canthus-to-orbital rim distance was less than 1 cm in 89% of patients.
The surgeons reported lower lid malposition correction in 127 lower lids (88%).
A negative vector anatomy may increase the likelihood of patients seeking a primary lower blepharoplasty, according to researchers.
The preoperative checklist can aid surgeons in choosing the most appropriate surgical technique and encompasses: Vector analysis; tarsoligamentous integrity; scleral show; canthal tilt; lateral canthus-to-orbital rim soft-tissue distance; midface position; and vertical restriction.
Disclosure: The researchers reported no relevant financial disclosures.