Westcott E-30440 00 Titanium Super Soft Grip Scissor, 10 cm- Grey/Yellow

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Ehrenhaus M, D'Arienzo P. Improved Technique for Temporary Tarsorrhaphy With a New Cyanoacrylate Gel. Arch Ophthalmol. 2003;121(9):1336–1337. doi:10.1001/archopht.121.9.1336. A #15 blade is used to make 2 parallel incisions that are connected at one end to develop two pillars of tarsoconjunctiva tissue, one corresponding to the medial limbus and one corresponding to the lateral limbus.

The final step is to create the drawstring, the 2 suture arms are passed through the 3rd bolster (it is commonplace to make this smaller than the other ones) A #15 Bard-Parker blade is used to cut through the skin and orbicularis adjacent to the canaliculus. Attention is then directed to the lower eyelid where a rectangle of tarsoconjunctival tissue is excised at the eyelid margin with the #15 blade and Westcott scissors at the level of each of pillar.

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

Hogeweg M, Keunen JE. Prevention of blindness in leprosy and the role of the Vision 2020 Programme. Eye. 2005: 19, 1099–1105. 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] Donnenfeld ED, Perry HD, Nelson DB. Cyanoacrylate temporary tarsorrhaphy in the management of corneal epithelial defects. Ophthalmic Surg. 1991;22591- 593.

Allen, R. “Pillar tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. As with any surgical procedure, there is a risk of bleeding, infection, swelling, and/or damage to surrounding structures. Other risks include premature separation, the need for reoperation, ankyloblepharon formation, pyogenic or suture granulomas, trichiasis, distichiasis, skin breakdown, lid margin deformities, and premature separation. [6] Pillar tarsorrhaphies have a unique complication of ectropion. [20] Reported side effects of neurotoxin tarsorrhaphies included preseptal hemorrhage, inadvertent injury to the globe, and superior rectus under action resulting in diplopia which can last up to 9 months after injection. [18] Outcomes 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. silk sutures are passed through the upper eyelid at the level of the meibomian gland orifices and the eyelid is everted over a speculum.Our Westcott Tenotomy Scissor comes with rounded tips that are ideal for blunt dissection of tissues. 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. An absorbable or nonabsorbable double armed 4-0 to 6-0 suture is initially passed through the bolster material. Allen, R. “Glue tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library.