Primary Repair of a Lid Defect with or Without Cantholysis

  • David G. BuergerEmail author
  • Daniel E. Buerger
  • George F. BuergerJr


The excision of a lid lesion must be performed with total removal of the lesion as the first priority. The type of repair chosen is based on the size of the defect, in conjunction with the degree of laxity of that eyelid. Reparative techniques must be approached as a continuum of repair, using the simplest, least-complicated technique possible and progressing to larger and more complicated procedures as the situation dictates. Although the exact extent of the repair technique is not known preoperatively, it is wise to at least have a game plan in mind. Although we are primarily concerned in this chapter with surgically created defects, the same principles and techniques apply to traumatic defects.


Eyelid defect Lesion Primary repair Cantholysis 

Supplementary material

419986_5_En_35_MOESM1_ESM.mp4 (98.7 mb)
Video 35.1 Full-thickness wedge biopsy and repair. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 101020 kb)
419986_5_En_35_MOESM2_ESM.mp4 (94.2 mb)
Video 35.2 Primary repair. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 96478 kb)
419986_5_En_35_MOESM3_ESM.mp4 (111.9 mb)
Video 35.3 Repair with lower cantholysis. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 114611 kb)
Video 35.4 Repair with upper canthotomy/cantholysis. Courtesy of Richard C. Allen, MD, PhD, FACS. (MPEG 71492 kb)


  1. 1.
    Hughes WL. Reconstructive surgery of the eyelids. 2nd ed. St. Louis: The C.V. Mosby; 1954.Google Scholar
  2. 2.
    Smith B. Ophthalmic plastic and reconstructive surgery, vol. 2. St. Louis: The C.V. Mosby; 1987.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • David G. Buerger
    • 1
    Email author
  • Daniel E. Buerger
    • 2
  • George F. BuergerJr
    • 1
  1. 1.Pittsburgh Oculoplastic AssociatesPittsburghUSA
  2. 2.Department of OphthalmologyUniversity of Pittsburgh Medical Center, Pittsburgh Oculoplastic AssociatesPittsburghUSA

Personalised recommendations