Can A Canthopexy Procedure Alone Lift The Lower Eyelid?

Q: Dr. Eppley, I wrote you about orbital rim implants some time ago. I am 42 years old and am interested in rim implants or canthopey or both. Do you see any problem in having only canthopexy to reduce scleral show and slightly tilt the eyes? The thing is when I tried fillers (which didnt change my problem much at all to be honest) the surgeon said that permanenet implants feel rigid that you can feel them all the time? I really would like to simply narrow and sharpen my eye shape, just concerned that a lot of people get either a “stretched look” or nothing at all?

A: When it comes to lifting up the lower eyelid to reduce scleral/orbital show, lateral tendon procedures are not going to shorten the ‘clothesline’ and lift the lower lid margin. That is simply asking too much of the procedure. There is a good correlation between the lower eyelid margin and the underlying bone support. The lower the bony orbital rim, the more likely the lid margin may also be lower or at least have less support. Therein lies the value of orbital rim implants, raising the bony rim and helping to push up the eyelid. and its lid margin. Lateral canthopexy has as role in the placement of orbital rim implants by providing suture support to the closure of the lower eyelid incision to decrease the potential of postoperatve ectropion.

Dr. Barry Eppley

Indianapolis, Indiana