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Updated: May 13, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Diagonal tarsal suture technique sine marginal sutures for closure of full-thickness eyelid defects
Andrea Willey1, Richard H Caesar
1Solano Dermatology Associates, Fairfield, California 94534, USA. andrea.willey@mac.com
Purpose:
Precise apposition of the tarsal plates and meticulous alignment of the eyelid margins are essential to ensure a seamless repair and avoid notching of the eyelid margin. The authors present a simple and reliable technique that firmly apposes and precisely aligns the eyelid margin in the x, y, and z axes, obviating the need for marginal sutures.
Methods:
A retrospective audit of electronic medical records was performed for all patients who underwent reconstructive procedures that included the repair of a full-thickness defect in the eyelid margin using the diagonal suture technique from 2003 to 2012.
Results:
Of the 652 surgeries performed in the past 9 years, 9 incidences of notching occurred, all of which were associated with infections.
Conclusions:
The diagonal tarsal suture technique is a simple and effective method for the repair of full-thickness defects with a high degree of patient satisfaction.

