• The eyelids are very vascular, and therefore they heal quickly in the correct conditions. Surgical management of many eyelid conditions involves suturing, and careful technique usually results in a good cosmetic and functional outcome.

Uses

• Repair of eyelid laceration Eyelid: laceration injuries.
• Repair of surgical incisions in the eyelid created during blepharoplasty techniques, such as entropion repair.
• Closure following a lateral canthotomy Eyelid: lateral canthotomy, usually done to increase globe exposure during corneal or lens surgery.
• Reconstruction after removal of eyelid masses Eyelid and conjunctiva: neoplasia.

Disadvantages

• The eyelids are very vascular and tend to swell, making suturing more difficult.
• Repair should ideally be carried out promptly in the case of injuries, as debridement is undesirable if avoidable.
• Delayed repair will require debridement, but this may be restricted to freshening up the edges of the wound with a scalpel.
• The eyelid margin needs to be precisely re-apposed. A step or notch defect may result in trichiasis or in uneven distribution of the tear film on the cornea.
• Sutures that are incorrectly placed full-thickness through the eyelid may result in the sutures abrading the cornea, leading to corneal ulceration Persistent corneal erosions.
• Whenever possible, the eyelid skin is preserved rather than resected. Eyelid pedicle injuries are replaced as they usually re-vascularize and heal well.
• Care is required when suturing near the nasolacrimal ducts, and cannulation is advised.