Simple Technique for Splitting the Lid in the Kuhnt-szymanowski Ectropion Operation.

THE usual procedure in the Kuhnt-Szymanowski operation is to commence by splitting the lid along the grey line. Sometimes there may be difficulty identifying this line and also the plane into which the splitting of the lid should be carried, because the lid margin is thickened and its direction distorted. It may be found helpful to reverse the order of the customary steps by first excising the triangle of skin at the outer canthus. This makes it possible to undermine with scissors the medial edge of this triangle, forming a tunnel in the desired plane of the substance of the lid. The undermining is taken right up to the roots of the lashes. It is now an extremely simple matter to complete the splitting of the lid using the scissors with one blade inside the substance of the lid and one blade along the outer aspect of the lid margin. Using small snips accurate splitting of the desired extent can be produced (Figure).