Lateral Tarsorrhaphy

Indications

Corneal exposure problems (e.g., facial nerve palsy, lid myopathies, thyroid ophthalmopathy).

Neurotrophic keratitis (e.g., diabetic patient, status post-herpetic infection).

Severe dry eye (e.g., keratoconjunctivitis sicca, ocular cicatricial pemphigoid, Stevens Johnson syndrome).

Sterile corneal ulceration.

Used in conjunction with amniotic membrane transplant for in ocular reconstructive procedures.

Preoperative Procedure

1. Attempt nonsurgical treatments tailored to the etiology of patient’s problem (e.g., lubricants, lid taping, bandage soft contact lens, punctal occlusion).

See Chapter 3.

2. For oculoplastic procedures, discontinue aspirin and nonsteroidal anti-inflammatory agents 10 days before surgery. Discontinue warfarin 2–3 days preoperatively, if medically possible.

3. Query patient about bleeding tendencies. A useful screening question is asking if the patient had unusual bleeding after dental extraction. Obtain hematological evaluation if bleeding tendency is suspected.