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

Abstract

Gold weight implantation provides significant reduction in lagophthalmos and significant improvement in corneal coverage. But owing to delayed closure time and disrupted tear film, irritation may persist. As a result, some patients require ongoing topical treatment of the eye, which can compromise visual acuity.

Type IV Hypersensitivity Reactions to Upper Lid Gold Weight Implants—Is Patch Testing Necessary?

“…Good results have been reported using upper lid gold weight implantation for lagophthalmos secondary to facial nerve palsy (Abell et al, 1998;Chapman and Lamberty, 1988;Chepeha et al, 2001;Harrisberg et al, 2001;May, 1987;Seiff et al, 1989;Sobol and Alward, 1990;Townsend, 1992) and although there is a range of potential complications, the overall incidence seems to be low. Many side effects can be minimised with attention to surgical technique (Kelly and Sharpe, 1992;Pickford et al, 1992) and good implant design, sometimes incorporating eyelets to aid suture fixation of the implant to the tarsal plate (Jobe, 1974).…”

“…The technique can improve eye closure, reduce the risk of exposure keratopathy and in partial palsies can actually increase the amplitude of upper eyelid movement with blinking (Abell et al, 1998). Reduced dependence on topical lubricants is often achieved (Chepeha et al, 2001). Gold weight implantation is a relatively straightforward technique.…”

Eyelid Lifting for Ectropion and Scleral Show in Facial Palsy Disease

“…shortening of the lower eyelid or weighted eyelid apposition [1], are very useful because they are rapid and simple to perform, but in general, they are paired with postoperative complications. Several attempts have been made to correct ectropion [7], both with techniques repositioning the tarsus [2] and canthopexy [3].…”

“…Many techniques have been used to protect the corneas of patients with facial paralysis: shortening of the lower eyelid, or weighted eyelid apposition [1], techniques of repositioning the tarsus [2] and canthopexy [3]. Many studies have attempted to establish surgical techniques which can both eliminate the pathology in the eye and are minimally invasive.…”

Correction of paralytic lagophthalmos

“…С того времени имплантат совершенству-ется постоянно: изменяется его форма и толщина; распо-ложение, форма и величина отверстий, что позволило снизить количество осложнений. В настоящее время в мировой практике наиболее распространены монолитные имплантаты из золота, весом от 0,8 до 2 г, имеющие не-сколько отверстий [3,14,[26][27][28][29].…”