LOWER-LID lag with rounding of the lateral canthus is especially common in patients wearing an ocular prosthesis over many years. This technique utilizes the lower lid as a sling. The lateral canthus is revised by the same procedure. Excellent results have been obtained for eight months. This is a preliminary report, since any procedure that is going to be proved effective must be followed up for over two to three years.
A lateral canthotomy is performed. The lower arm of the lateral canthal tendon is cut at its periosteal insertion (Fig 1). This releases the lower lid and allows it to be freely rotated. A 4-0 silk suture is placed in the cut end of the canthal tendon and the lid is brought up over the upper lid to determine the amount of shortening which is necessitated. This point is marked on the lid margin. Scissors are used to