View 2019 Abstracts

Stabilisation and elevation of the medial lower eyelid in facial nerve palsy (FNP) remains a challenge. Contributing factors include descent of the midface, loss of superficial preseptal and pretarsal heads of the orbicularis muscles, and the deep heads of the preseptal and pretarsal orbicularis muscles that attach to the lacrimal sac fascia and medial orbital wall. Skin contraction may also develop.

We have previously published a technique that plicates the medial canthal tendon (MCT) to the medial orbital wall and then suspends the lower lid with a “hammock” type suture sling to the lateral orbital wall. This is combined with a recession of the lower lid retractors and release of medial and lateral horns to reduce the downward pull and elevate the lower eyelid.

We show a surgical narrated video (6 min) of the above technique.

MCT plication with suture sling and retractor recession elevates and stabilises the lower eyelid with a posterior and superior vector fixation of medial canthus in patients with FNP.

This technique is our procedure of choice for lower eyelid ectropion and retraction in FNP and is useful for oculoplastic surgeon’s repertoire.