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Larissa Ghadiali, Gary J Lelli; Frequency of and factors associated with conversion from temporary to permanent tarsorrhaphy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3112.
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The purpose of this study was to examine the frequency of conversion from temporary tarsorrhaphy to permanent tarsorrhaphy and the factors associated with patients ultimately requiring permanent tarsorrhaphy. While multiple studies have addressed complications of temporary tarsorrhaphies, to the authors' knowledge, this is the first study to explore the conversion from temporary to permanent tarsorrhaphy.
A retrospective chart review was performed on patients who underwent temporary tarsorrhaphy placement between March 2009 and March 2013. A subset of these patients eventually required permanent tarsorrhaphy placement. Within this subset, we examined the original reason for tarsorrhaphy placement, average number of temporary tarsorrhaphies performed, type of temporary tarsorrhaphy suture used, reason for replacement, and complications associated with temporary tarsorrhaphy.
Forty-two eyes of 41 patients had temporary tarsorrhaphy placement with 10 eyes of 9 patients eventually requiring permanent tarsorrhaphy placement (23.8%). Within this group, reasons for tarsorrhaphy placement were thyroid eye disease (n=1), cranial nerve seven palsy (n=4), Crouzon syndrome (n=2), trauma (n=1), ocular cicatricial pemphigoid (n=1), and neurotrophic cornea (n=1). The total number of temporary tarsorrhaphies performed on this group was 37, with an average of 3.7 temporary tarsorrhaphies per eye. The temporary suture material used was 4-0 silk (n=35, 94.6%) and 5-0 prolene (n=2, 5.4%). The most common reason for replacement of temporary tarsorrhaphy was dehiscence (n=19, 51.3%) and suture erosion (n=4, 10.8%). Complications noted were discharge (n=4, 10.8%), patient discomfort (n=3, 8.1%), and eyelid edema (n=1, 2.7%).
Temporary tarsorrhaphies can be a useful short term option in patients with exposure keratopathy. However, the need to repeat temporary tarsorrhaphies is common and the rate of conversion to permanent tarsorrhaphy after multiple temporary tarsorrhaphies is relatively high. Careful selection of patients for temporary tarsorrhaphy is recommended and additional treatment options for exposure keratopathy should be considered.
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