Lateral canthal repositioning in syndromic, antimongoloid slant

INTRODUCTION: To report a single center's experience in correcting antimongoloid slant in Asian eyes using a minimally invasive approach. METHODS: Retrospective analysis of patients undergoing correction for antimongoloid slant at author's center, from 2007 to 2013 formed the study group. Concomitant surgical procedures were recorded. Pre- and post-operative photographs at the longest follow-up visit were analyzed and graded for functional and cosmetic outcomes. RESULTS: A total of 38 patients (76 eyelids) underwent successful correction to correct eyelid malposition. All patients’ eyelids underwent exclusive lateral canthoplasty through a small incision in the upper eyelid crease and re-suspension technique, and 6 of them underwent bilateral slant correction simultaneously with additional cosmetic or corrective surgeries including hemifacial microsomia and Crouzon's syndrome. Of the 38 patients, 25 were females and 13 were males. The age of the population ranged from 7 to 48 years with a mean age of 27 years. Few instances of transient postoperative chemosis lasting up to 2 weeks and minor infections were reported. All cases showed improvement in eyelid position (as assessed clinically and on photographs), 2 pediatric cases required reoperation in the following 2 years for the recurrent lower eyelid malposition and/or lateral canthal deformity owing to deviated basal bone growth. DISCUSSION: Lateral canthoplasty with resuspension technique can effectively address antimongoloid slant for an esthetically desirable lateral canthus.