Gold Weight İmplantation In Surgical Treatment Of Paralytic Lagophthalmos

Aim: Evaluation of the results of gold weight implantation to upper eyelid tarsal fold for surgical treatment of lagophthalmos developing due to facial paralysis. Material and Method: In our clinic, gold weight was implanted between December 2009 - December 2012to the upper eyelid tarsal fold of 15 patients developed lagophthalmos after facial paralysis. In addition, tightening and shortening operations were performed to lower eyelids for four patients with paralytic ectropion. The preoperative and postoperative findings of the patients were analyzed retrospectively. In addition to routine ophthalmologic examination, corneal complications of the patients due to lagophthalmos before and after surgery, the existence of the phenomenon of Bell and and corneal sensitivity were investigated. Weights of the gold implants to be applied were determined by trial sets. In the postoperative period, the level of ptosis caused by the weight of the gold implants were recorded. Findings: The mean age of the patients was 56 ± 20.2 years (17-84). The mean duration of facial paralysis and the mean follow- up period were calculated as 65 ± 88.7 months (2-264 months, median 24) and 16 ± 14 months (range 2-37 months, median 8), respectively. It has been seen that, high-grade (3-4 degrees) exposure keratopathy seen in all cases have disappeared in 13 patients in the postoperative period, regressed to first degree in 2 patients with preoperative corneal ulcer. It has been seen that, intense chemosis and hyperemia seen in preoperative period in all patients have completely regressed. Bell phenomenon was present in all patients. Corneal sensitivity has been decreased in patients with the etiology of cranial tumor surgery, was normal in patients with cerebrovascular events and idiopathic facial paralysis. The mean postoperative amount of pitosis was found to be 0.8 ± 0.14 mm. Conclusion: Lagophthalmos can be treated effective and in a good way in terms of cosmetic with gold weight implantation and operations performed for the lower eyelid. This surgical method m ay be an alternative for tarsorrhaphy operations.