tarsorrhaphy


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Tarsorrhaphy

 

Definition

Tarsorrhaphy is a rare procedure in which the eyelids are partially sewn together to narrow the opening.

Purpose

The eye needs the a lid to protect it. It also needs tears and periodic blinking to cleanse it and keep it moist. There are many conditions that impair these functions and threaten the eye, specifically the cornea, with drying. Until they can be corrected, sewing the eyelids partially together helps protect the eye.
A partial list of the conditions that can require tarsorrhaphy includes:
  • Paralysis or weakness of the eyelids so that they cannot close or blink adequately. Bell's palsy is a nerve condition that weakens the muscles of the face, including the eyelids. It is usually temporary. Myasthenia gravis also weakens facial muscles, but it is usually treatable. A stroke can also weaken eyelids so they do not close.
  • Exophthalmos (the eyes sticking out of their sockets) occurs with Graves' disease of the thyroid and with tumors behind the eyes. If the eyes stick out too far, the lids cannot close over them.
  • Enophthalmos is a condition in which the eye falls back into the socket so that the eyelid function is inadequate.
  • Several eye and corneal diseases cause swelling of the cornea and require temporary added protection until the condition resolves.
  • Sjögren's syndrome reduces tear flow to the point where it can endanger the cornea.
  • Dendritic ulcers of the cornea caused by viruses may need to be covered with the eyelid while they heal.

Precautions

The use of eye drops and contact lenses to moisten and protect the eyes must be considered first before tarsorrhaphy is performed.

Description

Stitches are carefully placed at the corners of the eyelid opening (called the palpebral fissure) to narrow it. This allows the eye better lubrication and less exposure to the air. Eyeball motion can then help bathe the cornea in tears when it rolls up under the lid. The outpatient procedure is done under local anesthetic.

Preparation

Tarsorrhaphy is a minor procedure done under local anesthesia. Special preparation is not necessary.

Aftercare

Eye drops or ointment may still be needed to preserve the cornea or treat accompanying disease.

Risks

Tarsorrhaphy carries few risks. If complications occur, they are usually minor eyelid swelling and superficial infection.

Resources

Books

Sardegna, Jill Otis, and T. Paul. The Encyclopedia of Blindness and Vision Impairment. New York: Facts on File Inc., 1990.

Key terms

Cornea — The clear part of the front of the eye through which vision occurs.
Enophthalmos — A condition in which the eye falls back into the socket and inhibits proper eyelid function.
Exophthalmos — A condition in which the eyes stick out of their sockets and inhibit proper eyelid function.
Palpebral fissure — Eyelid opening.
Sjögren's syndrome — A connective tissue disease that hinders the production of tears and other body fluids.

tarsorrhaphy

 [tahr-sor´ah-fe]
suture of a portion of or the entire upper and lower eyelids for the purpose of shortening or closing the palpebral fissure.

tar·sor·rha·phy

(tar-sōr'ă-fē),
The suturing together of the eyelid margins, partially or completely, to shorten the palpebral fissure or to protect the cornea in keratitis or in paralysis of the orbicularis oculi muscle.
[tarso- + G. rhaphē, suture]

tarsorrhaphy

/tar·sor·rha·phy/ (tahr-sor´ah-fe) suture of a portion of or the entire upper and lower eyelids together; done to shorten or entirely close the palpebral fissure.

tarsorrhaphy

(tär-sôr′ə-fē)
n.
Partial or complete suture of the eyelid margins to shorten the palpebral fissure or to protect the cornea.

tarsorrhaphy

[tärsôr′əfē]
a surgical procedure for temporarily or permanently uniting the upper and lower eyelids. It usually is performed in procedures to protect the cornea and may involve only the lateral parts of the eyelids.

tar·sor·rha·phy

(tahr-sōr'ă-fē)
The suturing together of the eyelid margins, partially or completely, to shorten the palpebral fissure or to protect the cornea in keratitis or in paralysis of the orbicularis oculi muscle.
[tarso- + G. rhaphē, suture]

tarsorrhaphy

Sewing together of the eyelids after removal of strips of marginal skin so that the raw areas heal together and remain closed. Tarsorrhaphy may be performed to conceal an unsightly and blind eye, but is also used to protect the CORNEA from drying and damage in excessive protrusion of the eye (EXOPHTHALMOS). BOTULINUM TOXIN can be used as a alternative in cases in which only a few weeks' coverage is needed.

tarsorrhaphy 

A surgical procedure consisting of suturing the upper and lower eyelids together either partially or completely. It provides a temporary protection to the eye or forms part of the treatment of dry eyes. See alacrima; keratoconjunctivitis sicca.

tarsorrhaphy

suture of a portion of or the entire upper and lower eyelids for the purpose of shortening or closing the palpebral fissure.
References in periodicals archive ?
This procedure has been proven to be safe and effective for the long-term management of the paralyzed eyelid, and it is preferable to tarsorrhaphy, which is associated with a poor cosmetic outcome and a limited visual field.
The upper and midface were suspended with a fascia lata graft, and a lower lid tarsorrhaphy was performed.
Other measures for the treatment of dry eye include increasing room humidity (eg commercially available radiator humidifiers), wearing swimming goggles to retain moisture, moisture release eyewear, and surgical options including tarsorrhaphy and salivary gland auto-transplantation.