From Big Medical Encyclopedia

BLEPHARORRHAPHY (Greek blepharon eyelid + rhaphe seam; synonym tarzorafiya) — surgery of reduction or full closing of a palpebral fissure. Can be B. temporary and constant. In the first case of B. the century, in the second only pulls together free edges — causes their strong union. Temporary full B. is shown at a lagophthalmia of various origin (paralysis of a facial nerve, an exophthalmos, etc.), at a nevroparalitichesky keratitis, a xerosis of a cornea. It can also precede such operations as an orbitotomy and an optikotsiliarny nevrektomiya (at glaucoma with pains), and sometimes to complete them. Temporary partial B. can be applied as a stage of operation in need of an immobilization of an upper eyelid.

Constant full B. is used at purpose of an ektoprotez (the prosthesis filling the lost part of the face). Constant partial B. is most often used at an ectropion of a lower eyelid and at a lagophthalmia.

Fig. 1. Temporary blepharorrhaphy according to Golovin: underrunning of a top and bottom century with setting of a node. Fig. 2. Blepharorrhaphy across Elshnigu. Imposing of vertical seams at an outside corner of a palpebral fissure after removal of an epithelium of intercostal space a century.

Golovin's operation can be an example of often applied temporary B., at a cut quite sufficient closing of an eye is reached by one seam (fig. 1). The same results can be achieved by imposing of several vertical seams. To Eagle stick in skin over eyelashes of an upper eyelid, remove in intercostal space of an upper eyelid, again stick in symmetric points of intercostal space of a lower eyelid and remove through skin under eyelashes; threads pull together and tie nodes on skin a century. Seams are removed in 2 — 4 days.

Fig. 3. Blepharorrhaphy but to Arlt. Imposing of vertical seams at an internal corner of the main crack after removal of an epithelium. Fig. 4. Blepharorrhaphy but to Rudin. Suture on edge a century after removal of an epithelium.

Constant B., as well as temporary, provides either full closing of a palpebral fissure, or only its reduction. Full B. is applied seldom. At this operation delete with scissors or a scalpel an epithelium intercostal spaces a century and the formed wound surfaces connect 5 — 6 vertically going seams. Seams delete on 6 — the 7th day. Partial B. at an outside corner of a palpebral fissure (a way of Elshniga, fig. 2) or at internal is more often made (Arlt's way, fig. 3).

Those and other operations (Rudin's way, fig. 4) are sometimes combined or put stitches in the middle of a palpebral fissure (Panas's way).

Bibliography: Golovin S. S. Inflammatory intradural tumors of an optic nerve, Vestn, oftalm., t. 31, page 391, 1914; Callahan A. Surgery of eye diseases, the lane with English, M., 1963; Colin A. A. The guide to plastic surgery in an eye, M., 1950; it. Operations for narrowing of a palpebral fissure and against a lagophthalmia, Mnogotomn. the management on glazn. Bol., under the editorship of V. N. Arkhangelsky, t. 4, page 131, M., 1959; P at V. Sluchay's dynes of Xerophthalmus'a cured by sewing together a century, Vestn, oftalm., t. 11, page 76, 1894; E 1 s with h n i g, Tarsorrhaphie, Z. Augen-heilk., Bd 33, S. 280, 1915; F o x S. A. Ophthalmic plastic surgery, N. Y., 1970; Hughes W. L. Lid reconstruction, in book: Affections of the lids, ed. by S. A. Fox, p. 224, Boston, 1964.

S. I. Talkovsky.