Tarsorraphy in the treatment of persistent corneal lesions

Altogether 38 tarsorraphies were carried out to 19 patients with corneal epithelial defects resistant to conventional therapy. The main operative indications were lagothalmos, dry eyes and inadequate blinking (6 patients). Corneal ulcer was detected in 17 eyes, six of which perforated. All patients had been treated from one week to 16 months (mean 3.5 months) without healing. Retarsorraphy was needed in 6 eyes. In perforations tarsorraphy was combined to tissue adhesive (3 eyes) or to therapeutic contact lens (4 eyes) or to conjunctival flap (2 eyes). The corneal epithelium healed in all except 2 cases (one perforation, one ulcer that is slowly improving). Five of the 6 perforations could also be cured without grafting. One eye of a severely debilitated patient was treated with a Gundersen's conjunctival flap and total tarsorraphy, but remained hazy. We consider, that tarsorraphy is valuable in treating corneal lesions due to lagophthalmos, dry eyes or disturbed lid function. It can also be used in threatening of manifest corneal perforation, if combined with the use of tissue adhesive or therapeutic contact lens.