Repair of Lateral Canthal Defect

This is Richard Allen at the University of lowa. This video demonstrates repair of a lateral canal defect. Repair of this defect will take advantage of shortening the posterior LA Mela in order to gain anterior lamellar redundancy. This is especially useful with anterior la mellor defects.The defect is noted in a lateral pathotomy is performed, followed by an inferior can lysis. A lateral tarsal strip is fashioned by dissecting between the anterior and posterior lamella for approximately one centimeter. The mucocutaneous junction of the posterior lamella is excised. The posterior surface of the strip is scraped and the strip is shortened. The strip will be sutured to the lateral orbital rim at the level of wital tubercle with a double arm four dasher meline suture on an S two needle.

By doing this, the posterior la melet is shortened,which then enables the defect in the anter lamella to be negated. In other words, by shortening the posterior LA melet in relation to the anterior lamellar defect, there is no dissociation in length between the anterior and posterior lamella. The strip of lashes is excised. A deep suture is placed with four dash zero Vicryl suture. This is placed in a buried fashion. As noted now, there is little tension on the anterior lamellar closure. The anterior lamella is then rea associated with the lateral tarsal strip in order to prevent a web.This is performed with five dash zero fast absorbing suture. The skin can then be closed with interrupted five dash zero fast absorbing sutures placed in a combination of interrupted as well as horizontal mattress sutures. At the conclusion of the case, the defect is repaired with minimal tension on the wound.