Case report of conjunctival sac fistula after cosmetic lateral canthoplasty

Abstract

Background: To report a case of conjunctival sac fistula after cosmetic lateral canthoplasty which is rare. Case presentation: A young women who underwent bilateral canthoplasty appeared with lacrimation of the right eye. We found there was a skin fistula with transparent tears at 2 mm lateral to the right canthus ligament and the liquid containing fluorescein was seen to overflow at the fistula after using fluorescein sodium eye drops. The number 7 lacrimal duct probe was visible under the temporal conjunctiva when exploring the fistula, and the fistula was about 4 mm. The patient was diagnosed with conjunctival sac fistula and fistula excision was performed. The patient did not tear abnormally after observation 3 months later and the incision healed well. Conclusions: The case report illustrates an uncommon post-lateral canthoplasty complication. We suggested that surgeons who perform this kind of surgery should ask about epiphora and look for conjunctival sac fistula at followup assessment.

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“…In a retrospective medical record review, four patients reported tearing from a lacrimal ductile fistula following lateral canthoplasty to lengthen a horizontal palpebral fissure [28]. Furthermore, it has been reported that during surgery, accidental suturing of conjunctival tissue with skin tissue resulted in the proliferation of conjunctival epithelial cells, leading to the formation of a fistula connecting the skin and conjunctival sac [29].…”

MZ Cat Eye Lifting: A New Cosmetic Procedure for Brow Lifting

“…In a retrospective medical record review, four patients reported tearing from a lacrimal ductile fistula following lateral canthoplasty to lengthen a horizontal palpebral fissure [28]. Furthermore, it has been reported that during surgery, accidental suturing of conjunctival tissue with skin tissue resulted in the proliferation of conjunctival epithelial cells, leading to the formation of a fistula connecting the skin and conjunctival sac [29].…”

Restoration of the Lateral Canthus and Stabilization of the Lower Eyelid After Failed Esthetic Lateral Canthoplasty

“…However, improper operations during the surgery sever the lateral canthus and lead to various complications 2 (Fig. 1A), including canthal webbing, rounding canthus, margin defect, remnant raw surface, mucosal exposure, sclera show, ectropion, lacrimal ductal fistula, 4 and conjunctival sac fistula 5 …”

“…1A), including canthal webbing, rounding canthus, margin defect, remnant raw surface, mucosal exposure, sclera show, ectropion, lacrimal ductal fistula, 4 and conjunctival sac fistula. 5 As the lateral canthus is anatomically where the upper and lower lids meet laterally, 6 symmetric, normally shaped, and positioned lateral canthus are the cornerstones of youthful periorbital appearance. 7 Revision of complications is of paramount importance to ensure appropriate canthal contour and eyelid function.…”