Early gold weight eyelid implantation for facial paralysis

Abstract

Facial paralysis can result in serious keratopathy because of corneal exposure and inadequate lacrimation. Thirty-seven patients underwent thirty-eight gold weight upper lid implants to rehabilitate paralysis of the eyelid from various causes. When indicated, implantation was combined with lower lid ectropion repair, medial canthoplasty or brow lift. Because of encouraging results in patients with longstanding facial paralysis, "early" implantation (within 1 month of paralysis) was offered to patients with severe lagophthalmos in whom (1) a severe neural injury was documented at the time of transtemporal surgery or (2) delayed, incomplete return of function was expected. Gold weight implantation resulted in excellent eyelid closure, protection, and cosmesis. There were no infections or extrusions. Lagophthalmos and exposure keratitis resolved or were significantly improved in all patients, and most were able to dispense with eyedrops and salves. Visual acuity improved in 95% of patients--a benefit even those without preoperative keratitis often achieved. A mild worsening of one patient's pre-existing astigmatism developed, which resolved after reimplantation with a lighter weight. The implant is easily removed from those patients who, having undergone early implantation, eventually recover adequate function. Gold weight loading has become our procedure of choice for eyelid rehabilitation.

Prospective Evaluation of Eyelid Function With Gold Weight Implant and Lower Eyelid Shortening for Facial Paralysis

“…Other studies have evaluated visual acuity in patients with gold weight implants who have had a similar surgical ap- proach. 12 These studies also show improvement in visual acuity, but incomplete normalization of visual acuity after gold weight implantation.…”

Tratamento do lagoftalmo paralítico com a utilização do implante de peso de ouro recoberto pela aponeurose do músculo levantador palpebral

“…A alteração inaceitável do relevo do peso de ouro sendo observado por transparência através da pele palpebral é um outro problema apresentado pelas técni-cas convencionais (27,28) . Ptose palpebral é um outro achado comum (23,28) após a simples inclusão do peso de ouro e se superior a 2 mm o tratamento cirúrgico está indicado.…”

“…Ptose palpebral é um outro achado comum (23,28) após a simples inclusão do peso de ouro e se superior a 2 mm o tratamento cirúrgico está indicado.…”

Uso de peso de ouro palpebral para correção do lagoftalmo em pacientes com paralisia facial

“…O implante de peso de ouro em pálpebra superior promove o fechamento ocular pela força da gravidade com o relaxamento do músculo elevador da pálpebra. É um método simples, de fácil reversão, com baixo índice de complicações e com bom resultado estético 5 . O fechamento ocular durante o sono pode ser adequadamente obtido com a ligeira elevação da cabeça com uso de travesseiro.…”