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Tarsorrhaphy

AI overview

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

Key points
  • It is performed to protect the cornea in cases of corneal exposure.
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    It may be done to protect the cornea in cases of corneal exposure
  • It is used as a treatment for proptosis and conditions causing eyelid paralysis, such as Graves' ophthalmopathy and Möbius syndrome.
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    as a treatment for proptosis (eye protrusion), for example, Graves' ophthalmopathy , Möbius syndrome and other conditions which cause eyelid paralysis
  • It is done to promote corneal healing in cases of corneal injuries and lesions.
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    It is also done to allow or promote corneal healing in cases of corneal injuries and lesions
  • The procedure is performed on the corner of the eyelid opening.
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    The procedure is performed on the corner of the eyelid opening
  • Tarsorrhaphy may be temporary or permanent.
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    Tarsorrhaphy may be temporary or permanent
Symptoms
  • Corneal exposure is a condition warranting the procedure.
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    cases of corneal exposure
  • Proptosis (eye protrusion) is an indication.
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    proptosis (eye protrusion)
  • Eyelid paralysis from various conditions is an indication.
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    other conditions which cause eyelid paralysis
Treatment
  • The most common technique is to partially suture the eyelids.
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    The most common technique for tarsorrhaphy is to partially suture the eyelids
  • Eyelids may be partially glued using cyanoacrylate glue.
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    the procedure may be performed by partially gluing the eyelids using cyanoacrylate glue
  • Botulinum toxin injections can be administered to paralyze the upper lid levator muscle.
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    injections of botulinum toxin can be administered to paralyze the upper lid levator muscle
  • A weight, often made of gold, can be attached to the upper eyelid.
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    attaching a weight, often made of gold , to the upper eyelid
  • The gold weight technique produces quicker results and is more suitable for patients with cancer.
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    The latter technique produces quicker results and immediately improves the quality of life, making it more suitable for patients with cancer
Red flags
  • Complications include failure to protect the ocular surface, dehiscence, trichiasis, pyogenic granuloma, corneal abrasion, haemorrhage, and infection.
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    Complications after surgery include failure to protect ocular or corneal surface, dehiscence , trichiasis , pyogenic granuloma , corneal abrasion , haemorrhage, and infection
  • Late referral in thyroid disease patients increases the risk of corneal ulcers and permanent corneal opacity limiting eyesight.
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    In cases of late referral to surgery in patients with thyroid disease, there is an increased risk of corneal ulcers and, consequently, permanent corneal opacity which limited patients' eyesight
Prognosis

Failure is more common in patients with prior ocular surgeries or systemic disorders such as diabetes mellitus and connective tissue disorders; late referral in thyroid disease patients risks permanent corneal opacity.

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Tarsorrhaphy
SpecialtyOphthalmology

Tarsorrhaphy is a surgical procedure in which the eyelids are partially sewn together to narrow the eyelid opening.[1] It may be done to protect the cornea in cases of corneal exposure, as a treatment for proptosis (eye protrusion), for example, Graves' ophthalmopathy, Möbius syndrome and other conditions which cause eyelid paralysis. It is also done to allow or promote corneal healing in cases of corneal injuries and lesions.[2] The procedure is performed on the corner of the eyelid opening.[3] Tarsorrhaphy may be temporary or permanent.[2]

The most common technique for tarsorrhaphy is to partially suture the eyelids, however in some cases the procedure may be performed by partially gluing the eyelids using cyanoacrylate glue,[4] injections of botulinum toxin can be administered to paralyze the upper lid levator muscle, or attaching a weight, often made of gold, to the upper eyelid.[2] The latter technique produces quicker results and immediately improves the quality of life, making it more suitable for patients with cancer.[5]

Complications after surgery include failure to protect ocular or corneal surface, dehiscence, trichiasis, pyogenic granuloma, corneal abrasion, haemorrhage, and infection.[6] In cases of late referral to surgery in patients with thyroid disease, there is an increased risk of corneal ulcers and, consequently, permanent corneal opacity which limited patients' eyesight[7] The vast majority of failed operations have been reported in patients who had ocular surgeries in the past, the rate of failiure is also higher in patients with systemic disorders such as diabetes mellitus and connective tissue disorders.[6]

  1. Beutner, Katherine (2025-04-29). "Tarsorrhaphy: the cornea's best friend". EyeWorld. Retrieved 2025-09-01.
  2. 1 2 3 Gounder, Pav; Selva, Dinesh; Rajak, Saul N. (2022-06-21). "Malignant lesions of the caruncle". Eye. 37 (5): 849–857. doi:10.1038/s41433-022-02124-0. ISSN 0950-222X. PMC 10050163.
  3. "Tarsorrhaphy". Encyclopedia of Surgery. Archived from the original on 18 April 2015. Retrieved 31 August 2015.
  4. Donnenfeld, Eric D.; Perry, Henry D.; Nelson, David B. (October 1991). "Cyanoacrylate Temporary Tarsorrhaphy in the Management of Corneal Epithelial Defects". Ophthalmic Surgery, Lasers and Imaging Retina. 22 (10): 591–593. doi:10.3928/1542-8877-19911001-09.
  5. Tan, Swee T.; Staiano, Jonathan J.; Itinteang, Tinte; McIntyre, Benjamin C.; MacKinnon, Craig A.; Glasson, David W. (April 2013). "Gold weight implantation and lateral tarsorrhaphy for upper eyelid paralysis". Journal of Cranio-Maxillofacial Surgery. 41 (3): e49–e53. doi:10.1016/j.jcms.2012.07.015.
  6. 1 2 Moura-Coelho, Nuno; Manero, Felicidad; Papa, Renato; Amich, Nicolas; Cunha, João Paulo; Güell, José Luis (2022-01-06). "Photorefractive keratectomy after DMEK for corneal decompensation by phakic IOL". European Journal of Ophthalmology. 33 (3): NP5–NP8. doi:10.1177/11206721211073429. hdl:10400.21/14207. ISSN 1120-6721.
  7. Grusha, Y.O.; Ismailova, D.S.; Fettser, E.I. (2021). "Tarsorrhaphy in rehabilitation of patients with thyroid eye disease". Vestnik oftal'mologii. 137 (5): 47. doi:10.17116/oftalma202113705147. ISSN 0042-465X.