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

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The needle is then turned around and passed 3-4 mm below the lower lid skin, through the lid margin and retrieved from the meibomian gland orifices. 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 mucocutaneous junction of the posterior lamella of the lower lid is excised using Westcott scissors.

In summary: The suture is passed through the bolster, followed by the upper eyelid, then the lower eyelid, then the second bolster. Once the second bolster is engaged, the suture is turned around and placed through the second bolster, then the lower eyelid, then the upper eyelid, and the bolster. The suture is then tied to complete the tarsorrhaphy. [12] If the eye needs to be opened the smaller bolster is separated from the larger lower eyelid bolster, which allows the eyelid to be examined or to receive treatment To retain a prosthesis, Boston Keratoprosthesis, or other device in patients with anophthalmia or after evisceration or enucleation 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.

Haag-Streit Group

Use of any tissue glue or cyanoacrylate glue gel can be a simple, alternative method for creating a temporary tarsorrhaphy unstable for invasive procedures, for temporary eyelid apposition for persistent epithelial defects, or for ease of use in any setting. [5] [15] Technique The temporary suture tarsorrhaphy can be placed anywhere along the lid margins. If inspection of the cornea at intervals is desired, a drawstring tarsorrhaphy technique can be utilized. Tanenbaum M, Gossman MD, Bergin DJ, Friedman HI, Lett D, Haines P, McCord CD Jr. The tarsal pillar technique for narrowing and maintenance of the interpalpebral fissure. Ophthalmic Surg. 1992 Jun;23(6):418-25. PMID: 1513540. The second arm of the double armed suture is then passed in an identical fashion along the other side of the bolster and through the eyelid as above Ellis MF, Daniell M. An evaluation of the safety and efficacy of botulinum toxin type A (BOTOX) when used to produce a protective ptosis. Clin Exp Ophthalmol. 2001;29(6):394–399.

Topical anesthetic is instilled, and the central area of the upper and lower eye lid is injected with local anesthetic (lidocaine 1-2% with epinephrine). 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 The suture is then tied over the bolster to complete the tarsorrhaphy. The suture should be snug to prevent incomplete lid opposition when intraoperative edema resolves.Lee V, Currie Z, Collin JRO. Ophthalmic Management of Facial Nerve Palsy. Eye. 2004; 18: 1225-1234. An absorbable or nonabsorbable double armed 4-0 to 6-0 suture is initially passed through the bolster material.

Our Westcott Tenotomy Scissor comes with rounded tips that are ideal for blunt dissection of tissues. 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. Allen, R. “Glue tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Tarsorrhaphy is a safe and relatively simple procedure in which part, or all the upper and lower eyelids are joined together to cover the eye partially or completely. Tarsorrhaphies are highly effective in the management of nonhealing epithelial defects and other corneal surface pathology by creating a more hospitable environment for corneal healing. [1] Tarsorrhaphies can be permanent or temporary, total or partial, and can be further classified into short duration tarsorrhaphies without sutures, temporary suture tarsorrhaphies, permanent suture tarsorrhaphies, and more extensive tarsorrhaphies that involve mobilization of skin or tarsal plate flaps. [2] Naik MN, Honavar SG, Bhaduri A, Linberg JV. Congenital horizontal tarsal kink: a single-center experience with 6 cases. Ophthalmology. 2007 Aug;114(8):1564-1568. DOI: 10.1016/j.ophtha.2006.12.001. PMID: 17367861.Allen, R. “Temporary bolster tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Inadequate blinking secondary to reduced corneal sensation, Riley Day Syndrome/Familial Dysautonomia, severe brain injury, or prolonged sedation [1] The needle is then passed through the meibomian gland orifices of the upper lid margin and retrieved 3-4 mm above the upper lid margin and engages the upper bolster. Especially includes narrow blades which increase precision. Moreover, the instrument has curved blades that contort to the surface of the eye for increased accuracy.

The anterior lamella of the lower lid is then sutured to the anterior lamella of the upper lid using absorbable or permanent 5-0 to 6-0 suture in an interrupted fashion. [1] [13] Made in premium quality stainless steel with satin finish to reduce glare. The instrument can be sterilized and reused. Specialty A medial tarsorrhaphy is another useful technique when applicable. This technique is modified to avoid damage to the canaliculi and involves making a V-shaped incision peripheral to the canaliculi to the upper and lower lids. The medial tarsorrhaphy is advantageous in that it does not interfere with peripheral vision.Cosar CB, Cohen EJ, Rapuano CJ, Maus M, Penne RP, Flanagan JC, Laibson PR. Tarsorrhaphy: clinical experience from a cornea practice. Cornea. 2001 Nov;20(8):787-91. doi: 10.1097/00003226-200111000-00002. PMID: 11685052.