The medial tarsal strip
D. R. Jordan, R. L. Anderson and S. M. Thiese
Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City.
Medial canthal malpositions and marked medial ectropion due to laxity,
scarring, or trauma can be difficult to correct. Medial canthal tendon
publications have been advocated but they do not achieve adequate posterior
and medial placement of the medial canthal angle and they lack permanence.
One of us (R.L.A.) has developed a surgical technique for correcting these
problems that is a modification of the lateral tarsal strip procedure used
to correct lateral canthal tendon laxity and malposition. The medial tarsal
strip procedure repositions and tightens the medial lower or upper eyelid,
establishing a normal anatomic appearance. Its use is indicated in cases of
medial canthal malposition or marked medial ectropion associated with a
nonfunctioning canalicular system or in those cases in which loss of
function of a patent canaliculus is acceptable or desirable. The advantages
of the medial tarsal strip are as follows: (1) surgery is directed at the
site of the defect; (2) recurrence of canthal tendon laxity and elongation
is avoided; (3) a more medial and posterior positioning of the medial
eyelid can be obtained; (4) any amount of eyelid laxity can be corrected
simultaneously; (5) the almond-shaped canthal angle is preserved or
reestablished; and (6) the procedure is fast and easily performed.
