Fig. 4. Medial canthopexy using Mitek bone anchor system.

(A) The medial orbital rim was accessed through a small transcutaneous incision. (B) The medial canthal tendon could be identified and the anchoring point of suspension was set just above to the medial canthal tendon insertion site. For the exposure of periosteum on the anchoring point, it was bluntly dissected, with care taken to prevent lacrimal apparatus injuries. (C) The Mitek system was applied. (D) The lateral tarsal string was suspended and fixed with adequate tension.