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Surgical technique: modified lateral tarsorrhaphy.

Don J de Silva¹, Yashin D Ramkissoon, Andre R Ismail

¹Adnexal Service, Moorfields Eye Hospital, London, United Kingdom.

Ophthalmic Plastic and Reconstructive Surgery

|February 18, 2011

Summary

A modified tarsorrhaphy technique effectively corrected mild inferior scleral show in thyroid eye disease patients. This eyelid surgery resulted in significant aesthetic improvement and high patient satisfaction with no complications.

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Area of Science:

Ophthalmology
Plastic Surgery

Background:

Thyroid eye disease can cause proptosis and eyelid malposition, leading to ocular surface exposure and aesthetic concerns.
Existing surgical treatments for eyelid sequelae of thyroid eye disease vary in complexity and complication rates.

Purpose of the Study:

To propose and evaluate a novel surgical technique for correcting inferolateral scleral show in mild cases of thyroid eye disease.
The technique is specifically designed for patients with 2 mm or less of inferior scleral show.

Main Methods:

A retrospective case series of 7 eyes from 5 patients who underwent the modified tarsorrhaphy procedure.
The technique involves lateral tarsorrhaphy marking, gray line split with anterior lamella excision, and lateral canthal tendon/tarsal plate suturing for canthal angle reformation.

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Main Results:

Mean inferior scleral show decreased from 2.0 mm to 0.3 mm postoperatively, with a follow-up of 49 months.
All 5 patients (7 eyes) reported satisfaction with the aesthetic outcome, and no surgical complications occurred.
One patient with significant proptosis later required orbital decompression.

Conclusions:

The modified tarsorrhaphy technique is effective for mild inferior scleral show (≤2 mm) in thyroid eye disease patients.
Careful patient selection and consideration of factors like previous surgeries are crucial for successful outcomes.
This technique offers a less complex option for managing specific eyelid malpositions secondary to thyroid eye disease.