Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Ophthalmic Disorder Syndrome in Unresolved Facial Palsy – Are We Managing It Right?
Author: Izabela Nowak-Gospodarowicz
ePoster Number: 246,00
Purpose
Facial palsy (FP) poses a diagnostic and therapeutic challenge for ophthalmologists, especially due to the lack of standardized care for incomplete eyelid closure. This study aimed to streamline patient management by identifying those at high risk for ophthalmic complications, pinpointing risk factors for weight failure, and assessing the cost-effectiveness of various procedures.
Methods
A prospective cohort study (2009–2024) analyzed 94 patients with FP using a multinomial logit model. Factors included age, FP etiology and duration, history of tarsorrhaphy, Bell’s and corneal reflexes, lagophthalmos in mm, and Schirmer test results. Since 2014, patients were randomized into three groups: GLE (gold weight low), GUE (gold weight upper), and PUE (platinum chain upper). Weight related complications and pharmacoeconomic effectiveness (ICER) were evaluated.
Results
Weight location significantly influenced postoperative inflammation and complications, with highest failure in GLE (100%) and none in PUE. Three clinical factors—prior tarsorrhaphy, good Bell’s phenomenon, and corneal reflex—significantly affected visual outcomes. Fibrotic encapsulation and immune response varied by weight placement.Cost-effectiveness analysis showed upper eyelid loading with gold weight was more efficient ($1241.74/QALY) than tarsorrhaphy, while platinum chain was less so ($13,181.05/QALY). Upper eyelid loading procedures were generally more cost-effective than tarsorrhaphy.
Conclusion
Simple clinical tests (Bell’s and corneal reflex) can predict ocular risk in FP patients. Weight location, not material, is key to avoiding complications. Gold-weights seem to offer the best value in FP eyelid correction.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Aleksandra | Kicinska | Military Institute of Medicine- National Research Institute |
| Michal | Kinasz | Military Institute of Medicine- National Research Institute |
| Marek | Rekas | Military Institute of Medicine- National Research Institute |
Abstract ID: 25-593
