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

Abstract

A personal and family history of gold allergy should be looked for before upper eyelid gold weight implantation. Patch testing should be performed for patients where there is doubt about whether gold has been the specific cause of previous allergic reactions, for patients who have undergone previous dental restoration involving gold, or if there is a positive family history of gold allergy.

Noninfectious inflammatory reaction to a gold weight eyelid implant: A case report and literature review

“…Although a rare complication, when it occurs, the outcomes tend to be poor, because most patients will require removal of their implant. Of the six patients described in the literature, five needed to have their implants removed after conservative management failed (5,8,9). The subject in our case also failed conservative therapy and required subsequent removal of her gold weight.…”

“…One retrospective review found two such cases, out of 62 procedures performed, over a nine-year period (8). Another study reported one case over a 10-year period at a single institution (5).…”

“…We have described one patient who experienced this reaction at our centre. Our literature search revealed only three articles that describe this complication, and they report on a total of six patients (5,8,9). Although a rare complication, when it occurs, the outcomes tend to be poor, because most patients will require removal of their implant.…”

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

“…O problema da reação tecidual ao implante foi praticamente resolvido com o uso do ouro puro, entretanto Seiff et al (23) , Bair et al (24) , Doyle et al (25) e Ritz et al (26) relataram reação inflamatória com edema crônico em alguns casos que necessitaram de remoção ou tratamento com infiltração local de corticóides.…”

Correction of paralytic lagophthalmos

“…Из осложнений при постановке монолитного им-плантата из золота наиболее часто встречаются: контури-рование имплантата, его миграция или обнажение, оста-точный лагофтальм, индуцированный астигматизм, птоз верхнего века и аллергическая реакция на золото [31,32,[38][39][40][41][42][43][44][45][46]. Пациентам с гиперчувствительностью IV типа к золоту можно рекомендовать имплантат, выполненный из платины или сплава платины и иридия [47].…”