Treatment of congenital forms of telecanthus with custom-designed titanium medial canthal tendon screws

A custom-designed, titanium medial canthal tendon screw (MCTS) was used successfully to correct telecanthus in three patients--two with blepharophimosis syndrome and one with congenital telecanthus. This device avoids the need for complicated transnasal wiring. Precise placement of the screw into the bone at the anterior lacrimal crest may be accomplished through a small skin incision. A through-and-through transverse hole in the screw just below its head allows passage of sutures and wires for internal fixation of the medial canthal tissues as well as for external fixation by a silicone stent. Correction of telecanthus with the MCTS is simpler and apparently a safer procedure than traditional transnasal wiring and, furthermore, may be easily combined with any soft tissue repair.