Clinical investigation of tarsorrhaphy suture for treatment thyroid-associated ophthalmopathy

Abstract

OBJECTIVE: To evaluate the indication and effectiveness of temporary tarsorrhaphy suture for the treatment of severe thyroid-associated ophthalmopathy (TAO). METHODS: From January 1990 to June 2004 total 41 cases were collected in the study which included 17 cases with exposure keratitis, corneal ulcer who couldn't use glucocorticoid and orbital decompression and 24 cases of cornea exposure after orbital decompression and radiation therapy for patients with TAO. Temporary lateral tarsorrhaphy were performed to 9 of all of the patients and temporary total tarsorrharhy to 32 patients. According to difference of ophthalmic inflammation glucocorticoid was used in 35 cases starting with the doses of 30-50 mg and taper off. Tarsorrhaphy suture was opened in 1-05 months postoperation. Clinical effectiveness of the treatment was observed. RESULTS: Visual acuity (VA) was significant improved from preoperation HM-0.5 to postoperation 0.1-0.8 (P < 0.05) in 17 cases of TAO after tarsorrharhy and taking corticosteroids. Eyelids were be able to close, keratitis and ulcer were healing. However cornea scar was found in 11 cases. Eyelid closed completely without corneal exposure after tarsorrhaphy in 24 cases of orbital decompression and radiation therapy. VA was improved from preoperation 0.1-0.7 to postoperation 0.4 approximately 1.0 with significant difference (P < 0.05). VA of patients underwent temporary lateral tarsorrhaphy was significant improved as well as VA of those underwent temporary total tarsorrharhy (P < 0.05). CONCLUSION: It may be a better choice to use tarsorrharhy suture for the treatment of TAO patients with corneal exposure and ulcer.