Operation. The speculum is inserted and opened as widely as possible. One blade of the scissors is passed into the cul-de-sac at the outer angle of the lid and the palpebral aperture enlarged by dividing the outer canthus horizontally. The external tarsal ligament which is split longitudinally is then cut across with scissors passed into the upper and lower wound. The conjunctiva is drawn up into the wound and stitched to the skin at the margin to prevent reunion. The stitches should be removed about the sixth day.
CANTHOTOMY
Canthotomy is simple division of the outer canthus without stitching the conjunctiva into the wound. It is useful in some cases of blepharospasm associated with fissure at the outer canthus.
CANTHORRHAPHY
Union of the eyelids, usually at the outer canthus.
Indications. (i) When the eyelids do not cover the globe as the result of—
(a) Cicatricial contraction of wounds, burns, &c., about the lid.
(b) Long-standing facial paralysis.
(c) Exophthalmic goître.
(ii) To help maintain the lid in position after ectropion operations.