Transcaruncular Medial Canthal Ligament Plication for Repair of Lower Eyelid Malposition

Objective To evaluate the long-term efficacy of transcaruncular medial canthal ligament (MCL) plication in the treatment of eyelid malposition. Methods Transcaruncular MCL plication was performed on 176 eyelids of 125 patients with symptomatic ocular exposure due to lower eyelid malposition in which MCL laxity was an important component. Preoperative and postoperative ocular exposure symptoms, lower eyelid position, lagophthalmos, and keratopathy were compared. Results At an average ± SD follow-up time of 25 ± 27 months (range, 1-103 months), 88% of preoperative symptoms resolved or improved. Lower eyelid position ( P P P Conclusions Transcaruncular MCL plication is a safe and effective technique for MCL laxity that contributes to lower eyelid malposition. This minimally invasive technique achieves good functional and cosmetic outcomes by re-establishing the vectoral forces for eyelid support that are normally provided by the tripartite ligament.