[Treatment of lagophthalmos with adhesive eyelid weights (reversible lid-loading)]

Area of Science:

• Ophthalmology
• Facial Nerve Surgery

Background:

• Lagophthalmic keratopathy, often resulting from facial palsy, traditionally uses hour-glass dressings.
• Hour-glass dressings can cause moisture chamber effects, visual impairment due to steaming, and potential dermal irritation.
• Gravity-dependent lid-loading with gold implants is an alternative for irreversible lagophthalmos.

Purpose of the Study:

• To evaluate the efficacy and patient acceptance of dynamic lead-weight lid-loading as an alternative to traditional hour-glass dressings.
• To compare the cosmetic and functional outcomes of lead-weight lid-loading with hour-glass dressings.

Main Methods:

• Lead weights (0.8-2.0 g) were affixed to the upper eyelid using well-tolerated adhesive layers or foil.
• The method was tested on 10 normal individuals before application to 22 patients with lagophthalmos, comparing it with hour-glass dressings.
• An additional 26 patients received the lead-weight lid-loading treatment.

Main Results:

• Dynamic lead-weight lid-loading proved effective and well-tolerated by patients.
• This method offered superior cosmetic acceptance and visual function compared to hour-glass dressings, particularly for daytime use.
• Hour-glass dressings remain relevant for severe nocturnal management.

Conclusions:

• Lead-weight lid-loading, applied with adhesive layers to the upper lid, is a recommended treatment for reversible lagophthalmos.
• This technique serves as a valuable preparatory step prior to potential gold implantation procedures.