Tarsorrhaphy.pptx

Tarsorrhaphy

1. Dr. Gariyashee Lahkar

2. INTRODUCTION INDICATIONS TYPES TECHNIQUES COMPLICATIONS OUTCOME CONCLUSION

3. Tarsorrhaphy is a surgical procedure in which part, or all the upper and lower eyelids are joined together to cover the eye partially or completely. M ain goals : Protect the cornea and ocular surface T o allow/promote corneal healing

4. Based on Duration,

5. Based on Extent,

6. A ccording to the position of the adhesion of the palpebral fissure,

7. Temporary tarsorrhaphy is the partial occlusion of the eyelids T emporary measure, where desired eyelid closure is < 8 weeks  C an be placed anywhere along the lid margins U se of bolsters is common in temporary tarsorrhaphy # Bolsters can be made of plastic, or of small cotton-wool balls. They are used to prevent the eyelid skin from tight sutures, and allow better suture tension control to close the eyelids the desired amount.

8. Permanent tarsorrhaphy involves intramarginal adhesion of upper and lower eyelids. It can be Lateral, Medial and Central/Pillar. Permanent tarsorrhaphy should be considered in the following cases: When maximal therapy has failed to treat corneal exposure, In cases where prolonged eyelid closure is desired When t he duration of time required is uncertain

9. Determine location and amount of tarsorrhaphy Infiltrate l ocal anaesthesia Clamp to improve haemostasis Separate the anterior and the posterior lamellae Posterior lamellae of both eyelids are sutured together Anterior lamellae of both eyelids are then sutured together

10. I ncision peripheral to the canaliculi to the upper and lower lids D oes not interfere with peripheral vision

11. T wo pillars of tarso -conjunctival tissue C entral area of the upper and lower eye lid S utures are tied to complete the tarsorrhaphy

12. Antibiotic ointment Appropriate topical lubricating drops and antibiotics Timely Follow up Avoid eye rubbing Avoid cosmetic application

13. Bleeding Infection Swelling Damage to surrounding structures Premature separation Ankyloblepharon formation Pyogenic or suture granulomas Trichiasis, distichiasis Lid margin deformities

14. S afe and effective procedure . Useful for treatment of nonhealing epithelial defects, corneal surface disease, and other ocular and eyelid disorders. O verall success rate for tarsorrhaphy: 80 to 100% . E ffects of traditional suturing techniques last from 2 to 8 weeks. T emporary tarsorrhaphies promote healing in 2 weeks and can be removed at that time. If adequate healing has not occurred and the patient requires long-term treatment, a permanent tarsorrhaphy can be performed which can still be opened at a later date.

15. Glue tarsorrhaphy: Cyanoacrylate glue used to temporarily occlude the eyelids Also known as “ superglue tarsorrhaphy ” Neurotoxin tarsorrhaphy: using Botulinum toxin type A Taping : temporary closure , < 24 hours M oisture-retaining eyewear: another temporary measure