Can A Lateral Canthopexy Fix Scleral Show?

Q: Dr. Eppley, I have a several questions regarding Lateral Canthopexy : 

1) is it enough to fix sclera show? If not, what additional procedures would be needed? 

2) is there any difference in outcome between Lateral Canthopexy and lateral canthoplasty? I’m aware that the method is different, but what about the outcome? 

3) I read that the results of Lateral Canthopexy can be short lived (sometimes as little as 6 months). Is this accurate? 

4) Is Lateral Canthopexy reversible? I know that canthoplasty isn’t, but because Canthopexy uses sutures, if they’re released will the eyelid revert to its original position? Knowing a procedure is reversible is comforting since one cannot perfectly predict how they’ll look, even with a perfect surgical outcome. 

Thank you for your time.

A: In answer to your lateral canthopexy questions:

1) Lateral canthopexy alone its never enough to correct scleral show. Either the infraorbital rim needs to be build or a lamellar layer of the lower eyelid needs to be grafted raise the lower eyelid up.

2) Lateral canthopexy and canthoplasty are different operations for different problems. They are not comparible or interchangeable procedures.

3) The duration of a lateral canthopexy depends on what it is being used for. If it used to correct scleral show it will be very short-lived.

4) Lateral canthopexy in the short term is reversible since it is a completely suture-based technique that is tightening an existing structure.

Dr. Barry Eppley

Indianapolis, Indiana