Modification of the Gold-Weight Implant for Insertion Into the Upper Eyelid in Facial Palsy

Abstract

Gold weight has been used as a lid-loading device in facial palsy for more than 50 years. This technique is frequently associated with certain complications like ulceration, migration, extrusion, etc. We have devised a new-shaped gold weight to reduce the rate of occurrence of these complications. This new implant has a large central fenestration. We believe that this shape reduces anterior surface contact and promotes fibrous healing through fenestration. This will keep the implant anchored in its position, hence, reducing the risk of ulceration, migration, and extrusion. We have been using this kind of implant for the last 2 years without any complication noted so far.

Gold weight implantation for rehabilitation of the paralysed eyelid

“…CHOI and DRISCOLL 3 presented a similar customized prosthesis with two holes for a patient who had an existing unaesthetic and non-functional eyelid implant. BHATTI et al 1 devised a gold weight with a large central fenestration that reduces anterior surface contact and promotes fibrous healing through fenestration. Although in the present series gold weights were without fenestration, no complications were observed during healing and follow-up period; additionally, the shape of the gold weight implants was more aesthetic due to being thinner.…”

Gold weight implants in the management of paralytic lagophthalmos

“…Paralytic lagophthalmos subsequent to facial nerve damage can have significant and profound long-term sequelae if it is not managed promptly and effectively. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The management algorithm depends on the severity and the likely duration of recovery (Table 2). Management can be broadly divided into surgical and non-surgical methods.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] It has gained widespread acceptance because of its low rate of complications and the relative simplicity of the surgical procedures. Though other materials have been used to load the upper eyelid, gold is considered the material of choice because of its inertness, high density, malleability, non-allergic properties and because it provides good colour camouflage in the Caucasian population.…”

“…A variety of surgical techniques have been described with differing success, these include tarsorrhaphies, muscle transfers, fascia lata and silicone slings, palpebral springs and upper eyelid weights. 13 Insertion of implants into the upper eyelid is a popular technique used to correct lagophthalmos, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] where lid closure is achieved by the gravitational action of the predetermined weight, while the functioning levator palpebrae superioris muscle is able to open the eyelid. Gold weights are the most commonly implanted material and have the advantage of being relatively inert, providing good colour camouflage, high density, malleable and non allergenic.…”

Acesso posterior para implante de peso de ouro

“…O implante do peso de ouro para a correção do lagoftalmo proporciona a oclusão palpebral pela ação da gravidade (5) . O motivo da escolha do ouro nessa técnica cirúrgica decorre das suas características físico-químicas, como a alta densidade, maleabilidade, pouca reatividade, coloração adequada para camuflagem abaixo da pele fina da pálpebra superior e fácil comercialização (6) . A popularidade desse tipo de implante aumentou gradativamente entre os cirurgiões oculoplásticos nos últimos 20 anos -o que resultou no surgimento de várias técnicas de implantação, como também em novas complicações (5) .…”