Upper eyelid retraction in paralytic lagophthalmos: one-snip procedure
Author: Jelena Juri Mandić
Base Hospital / Institution: University hospital center Zagreb, Medical School, University of Zagreb
ePoster presentation
Abstract ID: 24-463
Purpose
To present a novel surgical technique of a gold weight insertion for the upper eyelid retraction in patients with paralytic lagophthalmos.
Methods
In a period from 2021-2023, 25 patients with facial paralysis and upper eyelid retraction underwent one-day, local anesthesia surgery. Gold weight providing eyelid closure and free visual axis was determined preoperatively. Vertical incision was placed on the tarsus of the everted eyelid. Stevens scissors were used to create the space by blunt dissectioncarried out between tarsus and orbicularis muscle. Mosquito forceps was used to hold and place the weight into the created space. Weight position, upper eyelid dynamics and closure were checked at the end of the procedure.
Results
In all 25 patients the surgery went uneventfully. On three follow ups, weight position, eyelid dynamics, closure, tearing and anterior eye segment findings were evaluated. First follow up showed good position, adequate eyelid dynamics and free visual axis. Slit lamp examination showed improvement of corneal parameters. All patients reported improvement of the anterior eye segment symptoms related to tearing and foreign body sensation. No gold weight displacement, protrusion, extrusion, swelling, discomfort nor signs of infection were reported. Second follow up revealed gold weight displacement by turning vertically within the pocket in 1 patient. However, it did not compromise the function of the eyelid and the patient´s tolerability of the implant. Upon the third check up, 3 patients had incomplete closure due to the worsening of the lower eyelid laxity. 21 patient remained stable with no reported complications.
Conclusion
Patients with paralytic lagophthalmos and upper eyelid retraction are undergo surgery due to exposure keratopathy and tearing, resulting in decreased quality of life. Described method of one snip posterior gold weight insertion procedure is minimally invasive, quick, bloodless, sutureless, safe and effective in majority of patients in our cohort during 2 year follow up period. It might be a valuable alternative to standard surgeries.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Maja | Bakula | University hospital center Zagreb, Medical School, University of Zagreb |
| Krešimir | Mandić | University hospital center Zagreb, Medical School, University of Zagreb |
| Jasenka | Petrović Jurčević | Medical School, University of Zagreb |
| Marko | Jurčević | Faculty of Electrical Engineering and Computing, University of Zagreb |
| Antonela | Geber | University hospital center Zagreb |
