Can eyelid taping predict the benefit of a lateral tarsal strip procedure in patients with eyelid laxity and functional epiphora?

PURPOSE: To determine whether taping of the lower eyelid laterally and upward onto the temple region (to mimic a lateral tarsal strip procedure) can effectively predict whether lateral tarsal strip surgery will lead to resolution or improvement in functional epiphora by correcting eyelid laxity.

METHODS: A case series of 28 eyes in 20 patients with symptomatic epiphora and equivocal lateral eyelid laxity were identified. The inclusion criteria included patent nasolacrimal systems on syringing with no other eyelid malposition or obvious cause for epiphora. Patients underwent taping of the lower eyelid using micropore tape to the temple region in the outpatient clinic for a period of 1 hour. The patients were asked to spend that time in conditions that would exacerbate their epiphora (e.g., outdoors). At the end of the hour the patients were recalled for subjective reassessment of epiphora.

RESULTS: The mean age of the patients was 69 years. Eighteen patients (25 eyes) had subjective improvement in their epiphora when taped; this group was offered subsequent lateral tarsal strip surgery. Two patients (3 eyes) had no improvement in symptoms when taped. Postoperative follow-up showed decreased epiphora in 14 patients (20 eyes) of the 18 patients (25 eyes) operated. In 4 patients (5 eyes), although eyelid taping was beneficial, surgery did not resolve the epiphora.

CONCLUSIONS: Temporary tightening of the lower eyelid with micropore tape to mimic the effect of lateral tarsal strip surgery can identify those patients who may benefit from an eyelid-tightening procedure. Patients who did not benefit from eyelid taping can avoid potentially unnecessary eyelid surgery.