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.
Iowa Head and Neck Protocols
The lateral tarsal strip revisited. The enhanced tarsal strip
When senile involutional entropion develops, some changes are present in the anatomy of the lower lid. Generally in surgery, an ideal operation should be effective, cause minimal discomfort and morbidity, give an aesthetic result, and have a lasting effect. LSP produces a horizontal lid shortening with a diagonal tightening of the orbital septum and lower lid retractors,[ 7 ] producing an effective and long lasting improvement of both horizontal and vertical lid laxity. Olver describes the LSP as an operation in which the entropion repair is performed through only one 1-cm lateral canthal incision. Everting sutures are often performed in combination with LSP for better correction of the inward rotation of eyelid margin. Patients affected by entropion and treated with LSP recover very quickly, the cutaneous stitches being removed, in general, five days after the surgery.
Lateral Tarsal Strip
Ophthalmology and Visual Sciences. This is Richard Allen at the University of Iowa. This video demonstrates the lateral tarsal strip procedure. Dissection is then carried out between the anterior and posterior lamella for approximately 5 to 10 mm, depending on the laxity of the eyelid.
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