Abstract
Purpose :
To describe a method of temporary tarsorrhaphy augmentation using an add-on bolster element.
Methods :
The add-on bolster was made from 3 plastic tubings of approximately equal length, cut from a pediatric butterfly cannula or other IV tubing. One of the plastic tubings was cut lengthwise on one side. A double-armed non-absorbable suture, such as a 4-0 nylon, silk, or prolene, was passed in a horizontal mattress fashion through one wall of the cut tubing, and through the first uncut tubing. The same procedure is performed on the second uncut tubing, resulting in 3 cylinders connected by the 2 arms of the suture in a parallel fashion. Finally, the 2 needles were passed through the opposite wall of the original tubing, the one with the lengthwise cut, and tied in a horizontal mattress fashion.
Results :
The optimal size of the add-on bolster was calculated using a formula which includes the length of the tarsorrhaphy and the size of the palpebral fissure. A 17-year-old corneal graft recipient female with cicatricial lagophthalmos, the add-on bolster was slipped between the original tarsorrhaphy suture and bolster, augmenting its effect and resulting in re-approximation of the eyelid margins and protection of the ocular surface for an additional 2 months. The only complication observed was loss of the add-on bolster that was replaced.
Conclusions :
The use of the add-on bolster to augment a temporary tarsorrhaphy is a simple technique to salvage the suture tarsorrhaphy and prolong its usefulness.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.