Simultaneous reconstruction of medial canthus deformity and traumatic nasolacrimal duct obstruction using micro-anchors.

Purpose: To evaluate the efficiency and safety profiles of a technique of simultaneous reconstruction of traumatic lacrimal duct obstruction and medial canthus deformity using micro-anchors.

Methods: A retrospective interventional study was performed from 2018 to 2022 on 26 consecutive patients who presented with medial canthal deformities and traumatic nasolacrimal duct obstruction. All patients underwent medial canthoplasty using micro-anchors combined with dacryocystorhinostomy to address the traumatic nasolacrimal duct obstruction. Preoperative and postoperative measurements of telecanthus, the superior or the inferior displacement of the medial canthal tendon (MCT), surgical technique of MCT fixation, advantages and limitations of using micro-anchors, functional and cosmetic outcomes were recorded and compared.

Results: Satisfactory and symmetrical medial canthal fixation outcomes were achieved in 96% (25/26) patients using the micro-anchors. The surgical technique was easy and offered secure and reliable reattachment of the MCT in long-term. The DCR surgery was anatomically and functionally patent in 92% (24/26) patients. One patient had unsatisfactory medial canthal outcomes where the canthus remained partly lateral, and inferior compared to the uninjured side. The two failures following DCR surgery were secondary to complete cicatricial closure and had persistent epiphora.

Conclusion: The present study noted that micro-anchors can correct the medial canthal deformity and leave more space for the DCR osteotomy simultaneously.