Donnenfeld ED, Perry HD, Nelson DB. Cyanoacrylate temporary tarsorrhaphy in the management of corneal epithelial defects. Ophthalmic Surg. 1991;22591- 593.

Allen, R. “Temporary bolster tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Steiner GC, Gossman MD, Tanenbaum M. Modified tarsal pillar tarsorrhaphy. American Journal of Ophthalmology. 1993 Jul;116(1):103-104. DOI: 10.1016/s0002-9394(14)71755-6. PMID: 8328528. Lagophthalmos due to facial nerve palsies (neurogenic exposure keratopathy), cicatricial damage to the eyelids, anorexia nervosa, leprosy, Ramsay Hunt Syndrome Type 2, orbital tumors, and thyroid eye disease [1] [7] [8] [9]

Scissor - Iris, Curved, Sharp blades, Length 10cm

Inadequate blinking secondary to reduced corneal sensation, Riley Day Syndrome/Familial Dysautonomia, severe brain injury, or prolonged sedation [1] At OfficeStationery, we know a good quality pair of scissors is vital in any office or working environment. The best multi purpose scissors are titanium bonded scissors. These are strong but lightweight which makes them easier scissors to cut with. We have a huge range of these, as well as those with stainless steel blades. These are all manufactured by big brands including Scotch, Wescott, Leitz, Durable and more, which guarantees you the best quality every time. In addition, the operating scissor includes fine serrations to improve grip. It also has small blades to shank ratio for better control. A #11 or #15 Bard-Parker blade is used to make an incision along the grey line of the lateral lower lid of the desired length to a depth of 2 mm. Tarsorrhaphy is a safe and relatively simple procedure in which part, or all the upper and lower eyelids are joined together to cover the eye partially or completely. Tarsorrhaphies are highly effective in the management of nonhealing epithelial defects and other corneal surface pathology by creating a more hospitable environment for corneal healing. [1] Tarsorrhaphies can be permanent or temporary, total or partial, and can be further classified into short duration tarsorrhaphies without sutures, temporary suture tarsorrhaphies, permanent suture tarsorrhaphies, and more extensive tarsorrhaphies that involve mobilization of skin or tarsal plate flaps. [2]

The second arm of the double armed suture is then passed in an identical fashion along the other side of the bolster and through the eyelid as above Neurotrophic corneal ulceration (CN V deficit, herpes simplex virus (HSV) or varicella zoster virus (VZV) keratitis) [1] The anterior lamella of the lower lid is then sutured to the anterior lamella of the upper lid using absorbable or permanent 5-0 to 6-0 suture in an interrupted fashion. [1] [13]An absorbable or nonabsorbable double armed 4-0 to 6-0 suture is initially passed through the bolster material. Prior to the procedure, a full ophthalmic examination should be performed and documented. A thorough slit lamp biomicroscopic examination should document corneal pathology and the size and location of any defects or corneal ulcers. Careful examination of the palpebral conjunctiva using double eversion to look for foreign bodies or keratinization should also be performed. External examination of eyelid abnormalities, the degree of lagophthalmos, and assessment of corneal sensitivity are critical in determining what type of tarsorrhaphy is appropriate (permanent vs. temporary) and deciding on the extent of tarsorrhaphy (lateral vs. medial vs. central vs. total) to be performed. The length of tarsorrhaphy to be performed is determined by gently pinching the upper and lower eyelids together with forceps or manually to achieve desired closure. The needle is then turned around and passed 3-4 mm below the lower lid skin, through the lid margin and retrieved from the meibomian gland orifices. Two bolsters of the surgeon's choice of size and material (plastic tubing, red robin catheter, cotton wool balls, etc.) are prepared. If it is anticipated that the suture will be removed within 2 weeks and there is no skin compromise, bolsters may not be necessary.