Tarsorrhaphy - Clinical experience from a cornea practice

Purpose. To evaluate indications, success rate, and complications of tarsor rhaphy in a cohort of cornea and external disease patients. Methods. In thi s study, charts of patients who underwent tarsorrhaphies from January 1, 19 95, to September 30, 2000, were retrospectively evaluated. Information revi ewed included patient age and sex, indication for tarsorrhaphy, duration of signs and symptoms before tarsorrhaphy, time to epithelial healing after t arsorrhaphy, type of tarsorrhaphy (temporary/permanent), complications, tim ing of tarsorrhaphy removal, recurrence of signs and symptoms after complet e or partial opening of the tarsorrhaphy, number of tarsorrhaphies needed t o be replaced or extended, and duration of follow up. Results. Seventy-seve n patients were included in this study. Indications for a tarsorrhaphy were persistent epithelial defects or other ocular surface problems associated with neurotrophic ulcers, penetrating keratoplasty (PK), postinfection, exp osure keratopathy, surgery other than PK, dry eye syndrome, radiation kerat opathy, ocular cicatricial pemphigoid, Stevens-Johnson syndrome, entropion, and application of tissue adhesive. The epithelial defects in 70 (90.9%) o f the 77 eyes completely resolved. Overall, the mean duration of signs and symptoms before tarsorrhaphy was 89.8 +/- 27.8 days, and time-to-healing af ter tarsorrhaphy was 18.0 +/- 2.0 days. The difference between the duration of the signs and symptoms before tarsorrhaphy and time-to-healing after ta rsorrhaphy was statistically significant (p = 0.01). Of the 77 tarsorrhaphi es, 24 (31.2%) were temporary and 53 (68.8%) were permanent. Complications after tarsorrhaphy included trichiasis, adhesion between upper and lower li ds after tarsorrhaphy lysis, premature opening of the temporary tarsorrhaph y, pyogenic granuloma, and keloid formation of the eyelid. Conclusion. Tars orrhaphy is a very effective and safe procedure in the management of nonhea ling epithelial defects and other surface problems, with a 90.9% success ra te and only minor complications.