Transconjunctival Lateral Cantholysis for Closure of Full-Thickness Eyelid Defects

Purpose: To report a novel technique for closure of full-thickness eyelid defects too large for primary closure that avoids an external lateral canthotomy. Methods: Retrospective review of a consecutive case series of all patients undergoing transconjunctival lateral cantholysis. Results: Thirteen eyelids of 12 patients underwent transconjuctival lateral cantholysis for closure of a full-thickness eyelid defect. Each defect occurred after excision of an eyelid cutaneous malignancy. Each defect would not close primarily without undue wound tension. Average horizontal defect size measured 13.7 mm (range, 11-20 mm). Average follow-up interval was 2.3 months (range, 0.5-5 months). All defects healed well with no evidence of dehiscence, notching or other complication related to closure. No patient requested or required further surgery for any reason. Conclusion: Transconjunctival lateral cantholysis allows for closure of larger full-thickness eyelid defects and avoids morbidity from lateral canthotomy/cantholysis.