Knowledge of eyelid anatomy is critical before embarking on this oculoplastic technique. The suture should penetrate the tarsus or directly inferior to it, but care should be taken to avoid the inferior lateral punctum or canaliculus.
This technique is designed to prevent the eyelid from developing an ectropion in the postoperative period. It is not, however, able to correct an ectropion that is already apparent intraoperatively. Sutures may be removed approximately 3 days postoperatively, but may be left in place longer if a large amount of postoperative edema or bleeding is present.
The superior anchor point may be secured with adhesive strips and liquid adhesive if desired, which also permits adjustment of the tension across the suture in the postoperative period based on the degree of edema.