Augmentation of lateral tarsorrhaphy in lagophthalmos

Lagophthalmos, the inability to close the eyelids completely, is a serious condition caused by orbicularis oculi muscle paresis or paralysis. The standard lateral tarsorrhaphy may leave the eye open with corneal exposure. In those cases, we suggest that better approximation of the upper and lower eyelids will be achieved when the lower lid is retracted laterally and the upper lid medially. This yields satisfactory closure of the eyelids. I report herein four patients who were successfully treated with permanent lateral tarsorrhaphy with this approximation of the upper and lower eyelids with effective, satisfactory outcomes.