Canthoplasty involves the lengthening of the palpebral fissure at the external canthus. The canthus is divided outward to the extent designed with a pair of angular scissors, probe pointed ([Fig. 108]), and to the extent as shown in [Fig. 109].
Fig. 108.—Probe-pointed Angular Scissors.
The contiguous ocular conjunctiva is dissected ([Fig. 110]) up and attached to the newly made skin margin with silk sutures to prevent its reunion, one suture uniting the angle of the wound with the raised tip of conjunctiva ([Fig. 111]).
The sutures are allowed to remain about five days. Traction with the fingers should be made several times each day to thoroughly separate the wound and to prevent the contraction of the conjunctival triangle, which would offset entirely the object of the operation. As a rule the fine silk sutures heal out of the mucodermal margins owing to the softening of the tissue through the increased lachrymal secretion caused by the irritation of their presence and the resultant reaction following the operation.
Fig. 109. Fig. 110. Fig. 111.
External Canthoplasty.
A slight regional conjunctivitis usually follows this operation, yielding readily to simple treatment, often requiring no special care but the hygiene of secondary-wound antisepsis.