When Professor Imre, in 1943, cauterized a recurrent papilloma in the region of the caruncle, the upper and lower lids adhered to each other at the inner canthus while sparing the lacrimal puncta and canaliculi. This suggested to us that medial blepharorrhaphy might be usefully employed for treatment of everted puncta and for the ectropion due to facial paralysis.
Simple excision of 2 mm. skin strips, from the nasal canthus to the lacrimal puncta, with approximation of the inner lip by continuous suture and of the outer lip by interrupted sutures, was unsuccessful. The sutured lids soon separated. Such blepharoplasty was successful, however, when we excised, along with the skin, portions of the conjunctiva, the edge of the tarsus, and part of the caruncle as well.
A simpler and better procedure, which we now employ, is as follows: A curved incision beginning 1-2 mm. above the upper punctum, follows
KORCHMAROS I. Medial Blepharorrhaphy. Arch Ophthalmol. 1963;69(3):308-310. doi:10.1001/archopht.1963.00960040314008