Early Tarsorrhaphy in Conjunctival Chemosis After Orbit Bone Reconstruction

J Craniofac Surg. 2018 Jun;29(4):e359-e362. doi: 10.1097/SCS.0000000000004337.

Abstract

Objective: Chemosis is a common occurrence after orbital reconstruction surgery by the transconjunctival approach. The authors propose an early tarsorrhaphy approach for treating severe conjunctival chemosis following orbital fracture repair.

Methods: All severe conjunctival chemosis patients following orbital fracture repair were divided into 2 groups: tarsorrhaphy performed immediately when the eyelids could not close completely due to prominent conjunctival edema (early tarsorrhaphy, n = 10); and tarsorrhaphy performed 3 days after the appearance of severe chemosis (delayed tarsorrhaphy, n = 10). Once the conjunctiva subsided, the sutures were immediately removed. The duration of conjunctival edema was recorded.

Results: The average time to resolution of severe chemosis was significantly shorter in the early versus delayed tarsorrhaphy group (3.5 ± 0.5 versus 7.2 ± 1.73 days, P < 0.05). No recurrence of conjunctival edema occurred in any patient 4 months postoperatively.

Conclusions: Early temporary tarsorrhaphy is a fast and effective method for the treatment of conjunctival chemosis following orbital fracture surgery. The sooner eyelid suturing is performed, the faster conjunctival chemosis will subside.

MeSH terms

  • Adult
  • Cohort Studies
  • Conjunctival Diseases / surgery*
  • Edema / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures*
  • Orbit / surgery*
  • Orbital Fractures / surgery*
  • Young Adult