A Bloodless method of Tarsorrhaphy

Leela V. Raju MD
University of Pittsburgh, Pittsburgh, PA
Madhavi Ghanta DNB
Goutami Eye Institute, AP, India
V.K. Raju MD, FRCS
Monongalia Eye Clinic, Morgantown, WV
The authors have no financial interests to disclose.
Tarsorrhaphy is an important fundamental
ophthalmic technique and is indicated in a
variety of conditions to aid the healing process
of the cornea.
To describe a simple, bloodless method of
tarsorrhaphy that can be perfomed safely and
efficiently in any setting, e.g. a nursing home.
This procedure takes less time than other
methods of permanent tarsorrhaphy and does
not require suture removal.
5-0 or 6-0
Under local anesthesia, low
temperature cautery is used
to remove epithelium on the
lower and upper lid margins.
An 11 blade is
used to split
the lid at the
gray line into
the tarsoconjunctiva
and tarsomuscle of the
upper and
lower lids.
Any minimal
bleeding can be
absorbed with a
Q-tip at this time.
A 5-0 (or 6-0) double armed vicryl
suture is then passed (4-5mm
apart) through the skin just below
the ciliary margin, through the
split margins of the lower and
upper lids, and back out through
the upper lid skin.
This can also be done
with a single armed
suture. Before the suture
is tied, a small scratch is
made on the skin to bury
the knot.
ointment is
Usually a
patch is not
necessary as
there is
hardly any
In 75 cases, we have only experienced 2 broken
This method of tarsorrhaphy can be done in all
settings, especially in a nursing home where
follow up may be difficult
In our experience, this can be performed in a
bloodless fashion and reduce the amount of
postoperative medication- especially in dry eye
This method of tarsorraphy can be
done efficiently in any setting. Use
of vicryl suture precludes the need
for suture removal.
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