Lagophthalmos successfully treated by high pretarsal placement

Gold weights inserted using a high pretarsal placement can treat lagophthalmos, discovered a study in the British Journal of Ophthalmology.

A retrospective review, conducted by Dr Raman Malhotra and his team, Corneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, Sussex, UK, included 107 consecutive gold weight implants in 95 lagophthalmos patients studied over a 5 year period.

Gold weights were implanted using a combination of high pretarsal placement, levator recession and fixation. Revision surgery for the gold implants included repositioning, removing or exchanging the implants.

Photographs of each case were taken preoperatively and 6 months postoperatively in order to conduct a blind assessment of eyelid parameters.

Of the patients studied, five eyes needed three further revisions each. The indications for these revisions included 15 eyelids prominent implants, poor eyelid contour in 14 eyelids, extrusion in two eyelids and persistent erythema in eight eyelids. The revisions included six platinum chain exchanges, three replacements, eight repositioned implants and four removals.

Revision procedures were mostly completed within 12 months, with a complication rate of 1 in 6. The most frequent indications for revisions were unsatisfactory cosmesis from prominence of implant and poor eyelid contour.