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Medial Canthal Support Structures: The Medial Retinaculum A Review

Kang, Hyera MD*†; Takahashi, Yasuhiro MD, PhD*; Nakano, Takashi MD, PhD; Asamoto, Ken MD, PhD; Ikeda, Hiroshi MD, PhD§; Kakizaki, Hirohiko MD, PhD*

doi: 10.1097/SAP.0b013e3182a6365c
Review Article

The medial canthus is supported by several structures with a complicated 3-dimensional arrangement in a narrow space. Although the medial canthal tendon occupies a major portion of the area, the medial canthal support structures include the following entities: Horner’s muscle, the medial rectus capsulopalpebral fascia including the medial check ligament, the medial horn of the levator aponeurosis, the medial horn supporting ligament, the medial horn of the lower eyelid retractors, the preseptal part of the orbicularis oculi muscle, and 3 variations of the Lockwood’s ligament. We named the composite of these structures the “medial retinaculum,” which is similar to the “lateral retinaculum” of the lateral canthus. Profound comprehension and consideration of the medial retinaculum warrants safe and effective surgery in the medial canthal region.

From the *Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; †Department of Ophthalmology, Presbyterian Medical Center, Jeonju, Korea; Departments of ‡Anatomy, and §Pathology, Aichi Medical University, Nagakute, Aichi, Japan.

Received May 11, 2013, and accepted for publication, after revision, July 19, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Hirohiko Kakizaki, MD, PhD, Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan. E-mail:

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