Centurion Syndrome: anatomy, clinical manifestations, and management – a systematic review

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ABSTRACT Purpose To review the anatomical and clinical findings of Centurion Syndrome and explore possible surgical management options. Methods A systematic review of the literature on Centurion Syndrome was conducted. Studies that met clinical and anatomical criteria for Centurion Syndrome, written in English and published in peer-reviewed journals, were included. Results Out of 53 identified cases, approximately 46 underwent anterior medial canthal tendon (MCT) release with or without posterior fixation, or in combination with other procedures, and achieved total resolution of symptoms over varying follow-up periods. These findings underscore the significance of the anterior limb’s position in the pathogenesis of the syndrome and the necessity of surgically correcting it. Conclusion Anterior MCT release, with or without posterior fixation, is a commonly employed procedure to address punctal malposition in Centurion Syndrome. Additional interventions are often selected based on punctal and lid-globe status following tendon release.