Comparison of the outcomes of internal-fixation versus bolster-suture tarsorrhaphy

Purpose: To compare the outcomes of 2 techniques of permanent tarsorrhaphy. Methods: The clinical records of 30 patients who underwent tarsorrhaphy at a single university-based hospital clinic were reviewed. Patients underwent permanent tarsorrhaphy because they had a nonresolving facial palsy, neurotrophic keratopathy unresponsive to medical treatment, or both. Permanent tarsorrhaphies were carried out by either internal fixation tarsorrhaphy or rubber bolster suture tarsorrhaphy. Results: The overall success (100%) of internal fixation tarsorrhaphy on 12 patients (ages, 42.0 +/- 17.6 years) was significantly better than that of rubber bolster suture tarsorrhaphy (44.4%) on 18 patients (ages, 40.6 +/- 25.5 years) (Mann-Whitney U test, p = 0.01). Of the 10 patients who had unsuccessful outcomes, 8 (80%) had their eyelids separated within the first 3 postoperative weeks. Patients whose surgical outcomes were deemed successful were followed for a period of 21.4 +/- 10.7 weeks (range, 11-52 weeks). Conclusions: Internal fixation tarsorrhaphy is associated with a more favorable outcome than rubber bolster suture tarsorrhaphy in patients who require permanent eyelid closure.