LAUSR

BACKGROUND Canthopexies can be performed to modify the eye slant, both when the lateral canthus is lower than the medial one (congenital defect) or in case the patient asks for an almond-shaped eye (cosmetic indication). OBJECTIVES This peculiar type of canthopexy can be defined as "dynamic canthopexy," meaning that the later canthus is released from its original insertion and raised to a higher position. METHODS We reviewed 30 patients treated with a "dynamic canthopexy" between January 2005 to March 2015. 18 patients were affected by true down slanting palpebral fissure, while 12 patients had a normal eye shape, but were wishing for a more "Asian" look. Dynamic canthopexy involves a total modification of the canthal suspension system and its careful reconstruction at a higher level inside the orbital rim. In order to get a permanent result, canthal ligament and tendon had to be anchored to drill holes in the orbital rim bone with non-absorbable sutures. Symmetry was very carefully assessed. The average surgical time was 1 hour. RESULTS This surgery proved extremely effective in all cases. Patients must be warned, though, that an initial hypercorrection is necessary to achieve the desired canthal position. About 6 months after surgery the result of this operation can be considered permanent. Severe complications are rare. CONCLUSIONS Dynamic canthopexy can provide stable correction of anti-Mongolian slant. It can also be effectively used to obtain permanent slant eyes, when required by purely cosmetic patients. If precisely carried out, this technique can give very rewarding outcomes.