Comparison of Standard Eyelid Margin Closure Using Silk with a Modified Repair Using 7/0 Vicryl and a Buried Knot

Abstract

Aims: To assess the efficacy and complications of eyelid margin closure with 7/0 Vicryl or Vicryl Rapide suture with a buried knot at the grey line and to compare this with standard closure using silk with an external knot. Methods: Analysis of a prospective, non-comparative, interventional case series using 7/0 Vicryl or Vicryl Rapide with a buried grey-line knot (modified lid margin closure). Detailed assessment during the healing period was directed to (1) the lid margin profile, (2) the grey line suture and (3) the tissue reaction. Patients were seen for assessment within two days following surgery, at 14 days and at two months. A retrospective, comparative series of silk with an external knot (standard lid margin closure) and 7/0 Vicryl or Vicryl Rapide (modified lid margin closure) was also studied. An analysis was made of the hospital records of patients who had undergone direct lid margin closure with 7/0 Vicryl, Vicryl Rapide or silk. Short- and long-term complications were noted. Results: The prospective series included 24 patients whose lid margin closure had been performed with the modified technique with 7/0 Vicryl or 7/0 Vicryl Rapide. All lids healed well and there was no difference between these two sutures. The retrospective series included 123 patients. Seventy-one patients had the modified technique using 7/0 Vicryl or Vicryl Rapide. Fifty-two patients had lid margin closure with the standard technique using 6/0 silk. All lids healed well. In summary, in both the prospective and retrospective groups, no significant complications were encountered and the healing was excellent. Conclusions: 7/0 Vicryl and Vicryl Rapide with a buried knot at the grey line allows excellent lid margin healing comparable with standard closure using silk. Vicryl sutures do not need to be removed.

KEYWORDS:

• Eyelid surgery
• lid margin closure
• grey-line suture
• vicryl
• silk