Modern cataract surgery entails creating an opening into the interior of the eye, dissolving and suctioning away the cataract, and inserting an artificial lens to help with focusing. At the conclusion of the operation, the incision is, in many cases, left as is - unstitched or secured in any special way. The eye remains unpatched, and the patient is allowed to walk away from the operating room table. How is this possible?
With careful planning and precise placement of the initial incision, the tissues not only seal themselves but, in most cases, heal better and faster than if stitches were used. "Going stitchless" speeds up the operation by eliminating unnecessary manipulation of delicate tissue and decreases the chance of inducing astigmatism from overly tight or slightly misaligned sutures.
What's True for the Eye is True for the Lower Eyelid
Transconjunctival lower eyelid blepharoplasty (that is, a blepharoplasty undertaken through an incision made on the back side of the lower eyelid) offers a similar opportunity. When first described over a decade ago, the incision (which traverses nearly the entire length of the eyelid) was always stitched tightly at the conclusion of the operation.
Over time, though, some surgeons came to question the need for this final step . . .