Lower Eyelid Splinting: An Alternative to the Frost Suture

Abstract

The lower eyelid splint appears effective in maintaining lower eyelid position postoperatively. There were no complications with its use, and the splint was tolerated well. Benefits of the splint over the Frost suture include less risk of corneal abrasion, ability to check visual function, and ability to use the splint bilaterally.

Management of orbital complications in palatomaxillary reconstruction: A review of preemptive and corrective measures

“…31 In the early literature, the Frost suture was designed to provide upper eyelid support and/or corneal protection, and to correct ectropion. 30 Although they can be removed in as little as 3 days, 31 we recommend that these sutures remain intact for approximately 7 days postoperatively. 29,31 Immediately following surgery, the lower eyelid is particularly susceptible to contractile forces.…”

“…29 At the time of original publication, the Frost suture technique involved passing a suture through both the lower and upper eyelid, then subcutaneously to the supraorbital ridge. 29,30 However, modern surgical practice is to simply pass a suture through the tarsus (or slightly inferior) and subsequently attach the suture ends to the forehead with adhesive strips, tape, or suture. 31 In the early literature, the Frost suture was designed to provide upper eyelid support and/or corneal protection, and to correct ectropion.…”

“…The placement and duration of a Frost suture varies. 30 Although they can be removed in as little as 3 days, 31 we recommend that these sutures remain intact for approximately 7 days postoperatively. For larger defects, this period may extend to 10 to 12 days after surgery.…”

“…As an alternative method to the Frost suture, Jothi et al 30 described the lower eyelid splint. Lower eyelid splinting involves stitching a layered sheet of gauze along the orbital rim in three to four locations along the tarsus, applying two suspension sutures through the medial and lateral canthal tendons, and adjusting the sutures to raise the eyelid slightly above the inferior limbus.…”

Subciliary Incision with a Frost Suture: A Case Report Along with Review

“…The alternatives to frost suture are eyelid splinting and supportive tape, the main advantage of these techniques are preservation of the visual field and ability to inspect the eye while these support measures in place. Decreased risk of corneal abrasion is another theoretical advantage [5]. A barbed suture technique for suspension of lower lid after Mohs surgery also used as an alternative to frost suture [6].…”