Abstract
Background
Lateral canthal reconstruction performed to lengthen the horizontal palpebral fissure for aesthetic purposes is becoming more prevalent in Far East Asian countries. The lacrimal ductule fistula has become a complication of this procedure.
Methods
A retrospective medical record review was performed to analyze four patients (one man and three women) who presented with tearing from a lacrimal ductule fistula after cosmetic lateral canthoplasty for lengthening of a horizontal palpebral fissure. The average age of the patients was 27.3 years (range 21–32 years). The review analyzed patient data from previous surgeries, eye examinations, photographs, operative records, and pathology records.
Results
All the patients experienced tearing from a lacrimal ductule fistula after cosmetic lateral canthoplasty performed by four different plastic surgeons. Eye examination demonstrated tearing through one or more lacrimal ductule fistulas in scar tissue of the lateral canthal area. To relieve this symptom, two patients underwent excision of the lacrimal ductule and lateral canthal reconstruction. The symptom subsided postoperatively without recurrence. Pathologic examination performed for one patient showed the lacrimal ductule in the surgical specimen.
Conclusions
Lacrimal ductule fistula or exteriorization of the lacrimal ductule can complicate cosmetic lateral canthoplasty if precautions are not taken in the assessment of the patient or in the performance of the procedure. Excision is required to reconcile the symptomatic lacrimal fistula, whereas canthal reconstruction is needed to remedy the disfiguring lateral canthus to achieve appropriate canthal shape and position.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
This is a preview of subscription content, log in via an institution to check access.
References
Shorr N, Goldberg RA, Eshaghian B, Cook T (2003) Lateral canthoplasty. Ophthal Plast Reconstr Surg 19:345–352
Taban M, Nakra T, Hwang C, Hoenig JA, Douglas RS, Shorr N, Goldberg RA (2010) Aesthetic lateral canthoplasty. Ophthal Plast Reconstr Surg 26:190–194
Chong KK, Goldberg RA (2010) Lateral canthal surgery. Facial Plast Surg 26:193–200
Cook T, Goldberg RA, Douglas R, Eshaghian B, Shorr N, Fagien S (2003) The horizontal dynamic of the medial and lateral canthus. Ophthal Plast Reconstr Surg 19:297–304
Shin YH, Hwang K (2004) Cosmetic lateral canthoplasty. Aesthetic Plast Surg 28:317–320
Baek BS, Park DH (1998) Cosmetic and reconstructive oculoplastic surgery. Gunja Publishing Co., Seoul, pp 158–161
Blair VP, Brown JB, Hamm WG (1932) Surgery of the inner canthus and related structures. Am J Ophthalmol 15:498–502
Von Ammon FA (1841) Klinishe darstellungen derangeborenen Krankheiten und Bildungsfhler des Menschlichender auges und der augenlider. G. Reimer, Berlin, p 6
Fox SA (1976) Ophthalmic plastic surgery, 5th edn. Grune & Stratton, New York, p 233
Anderson RL, Gordy DD (1979) The tarsal strip procedure. Arch Ophthalmol 97:2192–2196
Bartisch S, Swartz KA, Spinelli HM (2012) Lateral canthoplasty using the Mitek anchor system. Aesthetic Plast Surg 36:3–7
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Leelapatranurak, K., Kim, J.H., Woo, K.I. et al. Lacrimal Ductule Fistula: A New Complication of Cosmetic Lateral Canthoplasty. Aesth Plast Surg 37, 892–895 (2013). https://doi.org/10.1007/s00266-013-0181-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-013-0181-6