From Big Medical Encyclopedia

CANTHOPLASTY (Greek kanthos a corner of an eye + plastike sculpture, plastics) — operation of lengthening and expansion of a palpebral fissure.

Fig. 1. The diagrammatic representation of operation of a canthoplasty on Ammona: at the left — a section of an outside palpebral commissure; on the right — a podshivaniye of the otseparovanny site of a conjunctival cover to a corner of a skin section.
Fig. 2. Diagrammatic representation of operation of a canthoplasty on Geyza: 1 — after a section of outside commissure make a vertical section of a conjunctiva of an eyeglobe; 2 — podshivany conjunctivas to a corner of a skin section.

It is shown at accretion of edges the century at an outside corner of an eye and during the narrowing a palpebral fissure (blepharophimosis), a cut can arise after burns, wounds a century, at hron, an inflammation of a conjunctiva and edges a century. To. it is for the first time offered Amman (F. A. Ammon, 1839). The essence of operation consists in plastics of the section of defect of fabrics of a conjunctiva which is formed later by its separating and a podshivaniye to a corner of a skin section (fig. 1). Quite often apply To. in modification To Geyza (V. Heuse, 1874). At the same time make a vertical section of a conjunctiva of an eyeglobe, external a limb on 3 — 5 mm. The Otseparovanny conjunctiva easily moves, and it is filed in a corner of a skin section (fig. 2). The defect formed at a vertical section of a conjunctiva of a sclera cicatrizes spontaneously.

To. in modification Blashkovich (L. Blaskovics, 1904) carry out as follows: in two millimeters from an outside corner a century on skin cut out an equilateral triangle, length of the party to-rogo 7 — 8 mm, the basis of a triangle shall be conditional continuation of a palpebral fissure. Then make canthotomy (see) and in the vertical direction partially cut a tarzoorbitalny fascia and fibers of a circular muscle along the outer edge of an eye-socket. On a wound horizontally put stitches. Then the conjunctiva is hemmed to a lateral corner of earlier formed skin triangle. The remaining defect is closed, sewing a conjunctiva with skin.

are put by Fig. 3. Diagrammatic representation of operation of a canthoplasty on Vinchentiis: at the left — after a section of an outside palpebral commissure, through a conjunctiva and skin carry out a matratsny seam by two needles; on a conjunctiva make two horizontal cuts; on the right — the matratsny seam is tied on the roller, two additional skin and conjunctival stitches are put (from above and from below)

At To. on to de Vintchentiis (de Vincentiis, 1928), in the field of an outside palpebral commissure make a deep intermarginalny section length apprx. 1 cm and glubiuoy 5 — 6 mm (fig. 3). Then for lengthening of a palpebral fissure do a horizontal section of skin 1 cm long. Skin is otseparovyvat from surrounding fabrics and cut an outside palpebral commissure. Put a matratsny stitch on two needles which stick 1 mm above and 1 mm below than the horizontal line which is conditionally connecting corners a century and bring threads of a seam through skin to 3 — 4 mm of a knaruzha from the termination of a skin section from within. To weaken a tension of a conjunctiva at pulling up of a matratsny seam, make two symmetric horizontal cuts of a conjunctiva, then slightly round off corners top and bottom skin rags. The Matratsny seam is tied on the roller and imposed two additional (one from above, another from below) skin and conjunctival a seam.

At considerable change of a conjunctiva (e.g., at trachoma) when it is difficult to stretch it, it is reasonable to carry out a canthoplasty in combination with change of a mucous membrane of a lip of the patient, replacing defect of a conjunctiva with a thin rag of this mucous membrane.

Most often apply To. across Amman in modification to Geyza, the positive effect in most cases gives edges.

Bibliography: Zaykova M. V. Plastic surgeries in ophthalmology, M., 1969; Colin A. A. The guide to plastic surgery in an eye, M., 1950, bibliogr.; Krasnov M. L. and Margolis M. G. Oftalmologiya of the ambulatory doctor, M., 1969, bibliogr.; The multivolume guide to eye diseases, under the editorship of V. N. Arkhangelsky, t. 4, page 127, M., 1959; F about x S. And. Ophthalmic plastic surgery, N. Y. — L., 1970; R o u g i e of J. Traitement chirur-gical du blepharophimosis, Ann. Chir, plast., t. 18, p. 141, 1973.

B. I. Morozov.