34 EyeWorld Asia-Pacific | June 2025 CORNEA Three cornea specialists and one oculoplastics specialist agreed that in some cases, closing the eyelid with either a permanent or temporary tarsorrhaphy is among the best treatments for corneal healing; the procedure is, in many ways, “the cornea’s best ally.” On the flip side, it’s not necessarily thought so by the patient—as Christopher Rapuano, MD, put it, “patients hate it”—and, as such, the decision often follows multiple failed healing modalities before patients accept the recommendation. “The biggest problem with a tarsorrhaphy,” said Christopher R. Dermarkarian, MD, “is that you’re going to lose either some or all of the field of vision. (…) You’re limiting how much the patient can see. That is a big drawback to tarsorrhaphy—patients lose their peripheral vision or their entire field of vision.” Dr. Rapuano, Dr. Dermarkarian, Kourtney Houser, MD, and D. Brian Kim, MD, gave their perspectives on when tarsorrhaphy is beneficial, different types of tarsorrhaphy, and how to help patients understand that while they might not want the procedure initially, it could, in many cases, accelerate healing for visual recovery—or, in severe cases, preserve the eye itself. Why Tarsorrhaphy? Dr. Kim shared that tarsorrhaphy protects the cornea because: 1) it limits corneal exposure to the environment, and 2) it limits corneal trauma from blinking. “The normal blink frequency is around 15–20 blinks per minute, and in the face of a persistent corneal epithelial defect or ulceration, the continual and repetitive movement of the eyelid over the cornea can undermine corneal healing,” he said. by Liz Hillman, Editorial Co-Director Tarsorrhaphy: The Cornea’s Best Friend Tape-splint tarsorrhaphy technique. A) The upper eyelid skin is cleansed of any sebum with an alcohol wipe to maximize adhesiveness of the tape. B) With the eyelid closed, the eyebrow is pulled upward in order to stretch the upper lid skin. C) A 1 x 1.5-inch piece of 3M transpore water-resistant plastic tape is applied to the eyelid horizontally with the superior border of the tape just underneath the eyebrow. D) Dr. Kim prefers to apply a second piece of tape to reinforce the splinting effect. The rigidity of the tape effectively creates a splint to maintain lid closure. E) Observe the splinting effect of the tape with improved closure of the eyelid. Source: D. Brian Kim, MD A C D B E
RkJQdWJsaXNoZXIy Njk2NTg0