Ellis MF, Daniell M. An evaluation of the safety and efficacy of botulinum toxin type A (BOTOX) when used to produce a protective ptosis. Clin Exp Ophthalmol. 2001;29(6):394–399. The suture is then tied over the bolster to complete the tarsorrhaphy. The suture should be snug to prevent incomplete lid opposition when intraoperative edema resolves.

Allen, R. “Lateral tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Proptotic exposure secondary to thyroid eye disease or other inflammatory orbital disease, and orbital tumors [1]Naik MN, Honavar SG, Bhaduri A, Linberg JV. Congenital horizontal tarsal kink: a single-center experience with 6 cases. Ophthalmology. 2007 Aug;114(8):1564-1568. DOI: 10.1016/j.ophtha.2006.12.001. PMID: 17367861. Allen, R. “Glue tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Tzelikis PF, Diniz CM, Tanure MA, Trindade FC. Tarsorrafia: aplicações em um Serviço de Córnea [Tarsorrhaphy: applications in a Cornea Service]. Arq Bras Oftalmol. 2005 Jan-Feb;68(1):103-7. Portuguese. doi: 10.1590/s0004-27492005000100019. Epub 2005 Mar 30. PMID: 15824813. Illustration of a Temporary Bolster Tarsorrhaphy step-by-step approach. Image drawn by Fabliha A. Mukit using an iPad and the Procreate app. Temporary Bolster Tarsorrhaphy Technique

Allen, R. “Temporary bolster tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library. Illustration of a Pillar tarsorrhaphy step-by-step approach. Image c reated by by Fabliha A. Mukit, MD using an iPad and the Procreate app. Technique The needle is then passed through the meibomian gland orifices of the upper lid margin and retrieved 3-4 mm above the upper lid margin and engages the upper bolster. The needle is then passed through the upper lid skin 3-4 mm above the lid margin, exiting through the meibomian gland orifices.If the eye needs to be opened the smaller bolster is separated from the larger lower eyelid bolster, which allows the eyelid to be examined or to receive treatment