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Lateral tarsal strip alongside adjunctive procedures remains a common method for correction of ectropion and entropion due to excessive lid laxity. However, this procedure leaves external scarring and other poor cosmetic features such as rounding of the lateral canthus post-operatively. Here we describe long-term outcomes of a simple transcanthal lateral canthopexy procedure for the correction of ectropion and entropion.

All patients undergoing transcanthal lateral canthopexy for the correction of ectropion and entropion were identified over a 4-year period. Surgery was carried out using a polypropylene suture to tighten and secure the lateral canthal tendon to the superolateral orbital rim. Inferior retractor repair was carried out when indicated. Patients were excluded if there was less than 6 months of follow-up. Improvements in lid position and laxity (objective) and symptoms (subjective) were recorded.

A total of 67 patients underwent transcanthal lateral canthopexy and met the inclusion criteria. Of these, 49 cases underwent ectropion correction. Objective lid position improvement occurred in all cases at final follow-up. Symptomatic improvement occurred in 85.6% and 80.0% were symptom free. Of the 18 entropion cases, lid malposition was corrected in all patients at final follow-up. Symptomatic improvement occurred in 100% of cases with complete resolution of symptoms in 88.9%. There were no intra-operative or post-operative complications.

Transcanthal lateral canthopexy is a reliable technique for the management of lid laxity and achieves superior cosmesis to traditional approaches.