The tarsal strip procedure
R. L. Anderson and D. D. Gordy
We have developed a procedure that is particularly useful for (1) paralytic
or senile upper and lower eyelid laxity, (2) lateral canthal tendon laxity
or malposition, and (3) iatrogenic phimosis associated with recurrent
entropion or ectropion after traditional lid-shortening procedures. Lateral
canthal tendon laxity or elongation is the primary problem in the majority
of these cases, and eyelid tightening with use of lateral tarsal strips
corrects this deformity. The midtarsal portion of the eyelid, which is
usually resected in traditional lid-shortening procedures, is seldom
elongated, and recurrences of laxity are common secondary to further
stretching of lax tendons. The technique involves a lateral canthotomy and
transection of the appropriate crus of the lateral canthal tendon. The
eyelid is then split into anterior and posterior lamellae, and tarsal
strips are fashioned from the posterior lamella. The tarsal strips are
sutured to periosteum at the lateral orbital wall, adjusting the height and
tension of the lateral canthus. This technique gives a normal appearance to
the lateral canthal angle and has yielded good results in 51 cases.
