ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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Upper Eyelid Weight Placement for Pediatric Lagophthalmos: Single-Institution Experience of 12 Patients

Author: Christopher Dermarkarian
ePoster Number: 224


The purpose of this study is to investigate characteristics of pediatric patients who underwent upper eyelid weight placement for paralytic lagophthalmos between 2014 and 2020 at a single institution.


Retrospective chart review.


12 (6 males, 6 females) patients (15 eyelids) with paralytic lagophthalmos were identified. The average age of the patient was 6.99 years. 50% of patients had a congenital syndrome. 67% of presenting lagophthalmos was due to a facial nerve palsy, 13% was due to CCDD, 7% was due to facial nerve hypoplasia and 13% were unknown. 20% of eyes had amblyopia. Prior to weight implantation, 73% of patients had corneal abnormalities on the affected side. 20% of the corneas on the affected side were noted to be neurotrophic. 66% of eyelid weights implanted were gold and 33% were platinum. 47% of the weights were placed in a pretarsal position while 53% were placed in a supratarsal position. 30% of gold weights extruded during follow-up. There were no extrusion events with the platinum weight. There was no association between the type of weight placed and extrusion (P = 0.51).


We believe the use of platinum weights may be more appropriate given that allergy to platinum is negligible. We recommend placing the weight in a high/supratarsal position as this is less likely to induce astigmatism. There may be an advantage to early weight placement, given that long-term facial nerve palsy is associated with upper eyelid skin retraction. Providers should consider corneal neurotization for those with neurotrophic corneas, as these patients are unlikely to tolerate contact lens therapies. This study is limited by the small number of patients, making it difficult statistically to affirm conclusions.

Additional Authors

First nameLast nameBase Hospital / Institution
NiloufarRohaniBaylor College of Medicine
RichardAllenBaylor College of Medicine

Abstract ID: 21-115