Lateral Tarsorrhaphy

What is tarsorrhaphy?

Tarsorrhaphy is the joining of part or all of the upper and lower eyelids so as to partially or completely close the eye. Temporary tarsorrhaphies are used to help the cornea heal or to protect the cornea during a short period of exposure or disease. Permanent tarsorraphies are used to permanently protect the cornea from a long-term risk of damage. A permanent tarsorrhaphy usually only closes the lateral (outer) eyelids, so that the patient can still see through the central opening and the eye can still be examined.

What is the goal of lateral tarsorrhaphy?

The goal of lateral tarsorrhaphy is to protect the cornea and reduce symptoms of exposure, such as excessive tearing and pain.

Lateral Taesorrhaphy surgery?

The procedure involves attaching the lateral portion of the lower and upper lids together to partially close the eye. It can be a temporary solution or a more definitive one.

The most commonly used tarsorrhaphy in paralyzed eyelids is permanent tarsorrhaphy, even if the patients are often unhappy due to both obstruction of lateral vision and cosmetic appearance.

Technique

This procedure can be performed either under local or general anaesthetic.

Incision

An incision is made in the lateral 1/4 to 1/3 of the upper and lower eyelid, stopping short of the lateral limbus of the iris.

Lamellae splitting

The anterior and posterior lamella is split along the grey line to a depth of 3-5 mm.

A thin portion of the epithelium of the lid margin can be excised at this stage in order to reduce the risk of dehiscence.

Suture

The posterior lamella, followed by the anterior lamella, of the upper and lower eyelids are sutured together using a resorbable suture.

The posterior lamella sutures are inverted (buried) to prevent corneal irritation.

Care should be taken not to damage the eyelashes as this procedure is often reversed at the time of definitive eyelid surgery for eyelid closure.

Aftercare:

Lubrication

It is important to maintain the lubrication and protection of the eye.

The lubrication consists of natural tear substitutes during the day and ointment based lubricants during sleep, often together with taping the eyelid closed.

Protection

Physical protection through eyewear may be necessary depending on occupation and environmental conditions.

NEXT STEP

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• The name of the test or procedure
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• What the possible side effects or complications are
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• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
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