Vol. 2, Issue 1, Part A (2020)

Objective: To characterize the outcomes of pillar tarsorrhaphy in patients at Jinnah Postgraduate Medical Centre. Material and Methods: It’s a single arm, open label, Non-randomized clinical trial study in which total 35 subjects were studied at Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2019 to December 2019. All the patients were suffering from ocular surface diseases of cornea due to various causes, from mild to severe (impending perforation) corneal ulcers. The procedure involves formation of two rectangular tarso-conjunctival flaps from upper lid as pillars. These pillars are sutured into an area of excised tarso-conjunctival gutter below the inferior margin of lower lid tarsus positioning the medial aspect of each at corneoscleral limbus along with a bolster applied to suture that is removed after 1 day. Follow-up performed till 4months. Results: Total 35 patients with a mean age of 50.7±13.7 years (range, 10-72 years) were studied. Out of 35, only 5 (14.3%) went into failure, and 30 (85.7%) showed successful results. A total 12(34.4%) diabetic, 13(37.1%) hypertensive and 10(28.6%) both diabetic and hypertensive was found in the study group. The main types of diseases for tarsorrhaphy was corneal ulcers 14(40%), facial palsy leading to exposure keratopathy 06(17.1%), amniotic membrane graft due to corneal thinning 04(14.4%), corneal ulcer with descemetocele, and corneal abscess with thinning 04(14.4%). The less common type of disease was tectonic graph 02(5.7%) and exposure keratopathy 02(2.9%). Conclusion: Tarsal pillar tarsorrhaphy is successful as both permanent and reversible technique for narrowing interpalpebral fissure in order to protect corneal surface, providing satisfactory results by maintaining eyelid contour, better drug instillation and compliance as well as convenient for ophthalmologist for slit lamp examination of the cornea