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Upper eyelid full-thickness eyelid defect with 30-60% of horizontal tissue loss is reconstructed by primary closure as described above after release and advancement of lateral tissue by lateral canthotomy followed by cantholysis.
If significant horizontal laxity was present (identified with an eyelid distraction test, snap back test, or both preoperatively), a lateral canthotomy and inferior cantholysis were performed before securing the tarsoconjunctival flap to the posterior lamella.
The patient was also found to have an elevated ocular pressure, so she agreed to canthotomy and cantholysis to lower it.
There is dark thickening typical of a cantholysis Neighbor can't.
Wide excision of the lesion along with lid margin and lid reconstruction with direct closure a lateral cantholysis was done.
If there is any sign of deterioration of vision, surgical exploration of the wound, cantholysis, and orbital decompression should be undertaken.
Lateral cantholysis and placement of near-far, far-near sutures may be necessary to minimize horizontal tension8.
Later in the day her visual acuity had deteriorated to 2/21 and an urgent lateral canthotomy and cantholysis was performed.