The tarsal strip procedure is an ophthalmic surgery designed to correct eyelid malposition and restore proper function. It focuses on tightening and repositioning the lower eyelid, addressing issues that can affect vision and eye comfort.
What is the Tarsal Strip Procedure?
The tarsal strip procedure is a surgical technique primarily used to tighten and reposition the lower eyelid. Its main purpose is to correct eyelid laxity, which can lead to the eyelid turning outward or inward. This procedure typically involves the lateral canthus, the outer corner of the eye where the upper and lower eyelids meet.
The technique provides structural support to the eyelid by modifying the lateral canthal tendon. This helps increase the horizontal tension of the eyelid, ensuring it sits correctly against the eyeball. This adjustment helps improve both the functional alignment of the eyelid and its cosmetic appearance.
Common Conditions Addressed
The tarsal strip procedure is commonly performed to treat specific eyelid conditions, mainly ectropion and entropion. Ectropion is a condition where the lower eyelid turns outward, pulling away from the eye. This outward turning can expose the inner surface of the eyelid and the eye, leading to symptoms like dryness, irritation, and excessive tearing.
Entropion involves the inward turning of the eyelid margin, causing the eyelashes to rub against the cornea and ocular surface. This rubbing can cause discomfort, foreign body sensation, and potentially lead to corneal abrasions, scarring, or ulceration. The tarsal strip procedure addresses the underlying eyelid laxity in both conditions by tightening the horizontal dimension of the lower lid, which helps to restore the eyelid’s proper position against the eye. It can also be used for severe eyelid laxity due to aging, paralysis, or trauma.
The Surgical Process
The tarsal strip procedure is typically performed as an outpatient procedure, meaning the patient can usually go home the same day. It is commonly done under local anesthesia, often with additional sedation for patient comfort. The local anesthetic is injected into the eyelid skin.
The surgeon begins by making a small incision at the outer corner of the eye, known as a lateral canthotomy. The lateral canthal tendon, which anchors the eyelid, is then detached from its insertion point. The eyelid is separated into two layers, and a strip of tissue, called the tarsal strip, is created from the posterior layer. This strip is then pulled horizontally and reattached to the periosteum, the tissue covering the bone of the lateral orbital rim, using sutures. This reattachment tightens the lower eyelid, restoring its proper tension and position.
Recovery and Post-Procedure Care
Following a tarsal strip procedure, patients can expect common post-operative symptoms, including swelling, bruising, and mild discomfort around the operated eye. These symptoms are typically most noticeable in the first 24 to 36 hours and may extend to the lower eyelid and cheeks due to gravity. To manage swelling and bruising, applying cold compresses or ice packs to the closed eyelid for 5-10 minutes every hour during waking hours for the first three days is recommended.
Patients will usually be prescribed antibiotic eye drops or ointment to prevent infection, applied as directed. Pain medication, such as paracetamol, can alleviate any discomfort. Stitches on the skin are often removed after three to five days, while deeper sutures may dissolve or be removed around seven to ten days post-surgery.
Patients are generally advised to avoid strenuous activities, swimming, and wearing eye makeup for at least two weeks to allow for proper healing. Most individuals feel comfortable returning to public activities within two weeks, although some residual swelling may persist for up to four months. Follow-up appointments are usually scheduled within one to two weeks to assess healing and address any concerns. While complications are uncommon, patients should seek medical attention if they experience severe pain, excessive swelling that prevents opening the eyelid, or signs of infection.