Tarsorrhaphy: Benefits and Procedures

What is tarsorrhaphy?

Tarsorrhaphy, also known as blepharorrhaphy, is a procedure in which a surgeon joins the upper and lower eyelids together to cover the eye partially or completely. This procedure aids in protecting the corneal surface of the eye while promoting and accelerating the healing process. 

Tarsorrhaphies are classified as either temporary or permanent. If the tarsorrhaphy is temporary, the cornea is expected to heal within two to eight weeks. If healing has not taken place within those weeks, the surgeon will perform a “permanent” tarsorrhaphy when eye closure is needed longer-term. The surgeon can then open the eye at a later time. 

This procedure can also be performed on dogs and cats if their eyeball has been displaced following an injury. 

Indications

Your eye doctor may recommend tarsorrhaphy when the cornea is unable to heal — due to an injury, surgery or the effects of disease — without additional protection. Conditions and situations that may benefit from tarsorrhaphy include:

• Dry eye that doesn’t respond to conventional treatment

• Cicatricial conjunctivitis, inflammation and scarring of the conjunctiva due to different underlying conditions

• Epithelial (outermost layer of cornea) defects that will not heal while the cornea is exposed

• Corneal ulceration associated with infectious keratitis, or infection of the cornea 

• Progressive corneal thinning

• Stem cell deficiency in the limbus, which is the border between the cornea and the sclera (the white part of the eye)

The cornea may require protection from exposure in cases of: 

• Lagophthalmos, a condition in which the eyelids do not fully close. This is often caused by facial paralysis

• Bulging eyes, which are sometimes seen with thyroid eye disease

• Eyelids that are no longer in the correct position because of trauma or surgery

• Floppy eyelid syndrome, a condition where the upper eyelids are loose and may flip inside out

• Poor blinking rates related to certain neurological diseases or extensive sedation

A doctor may also recommend tarsorrhaphy following certain surgeries. This is done to prevent exposure and swelling. Some of those surgeries include, but are not limited to:

Tarsorrhaphy may also be done to help secure a prosthetic eye (also called an artificial eye).

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