The Use of Gold Weight Implants in Paralytic Lagophthalmos

Objective: To evaluate the complications and effectiveness of eyelid gold weight implants in the treatment of paralytic lagophthalmos. Patients and Methods: 21 patients (age 23 -77, mean 50 years) with established diagnosis of facial palsy consented to be included in this study. All of these patients had treatment of lagophthalmos with eyelid gold weight implants following a standard clinical assessment and surgical protocol. A review questionnaire was designed to assess the complications, effectiveness and the treatment outcome. Results: The commonest cause of facial palsy was surgery due to acoustic neuroma. The average implant weight was 1.5g with a range of 0.9 - 2.6g. Two implants were removed due to recovery of nerve function and two due to infection. One implant 2.6g was too heavy and was replaced with 1.3g implant. Ancillary procedures included 3 medial canthoplasty and 4 XII –VII anastomosis. 14 out of 14, who completed questionnaires (100%), patients had their lagophthalmos corrected. Overall 11 out of 14 (75%) patients were satisfied with the treatment. 62% had improvement in voluntary and 38% involuntary blinking. Most post operative complication resolved within few weeks. Conclusions: All patients achieved good initial eye closure with adequate corneal protection. The use of eyelid gold weight implants is an effective treatment of paralytic lagophthalmos.