Research Article
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Custom-Made Gold Implant Experiences in Lagophthalmos Treatment

Year 2025, Volume: 11 Issue: 2, 239 - 244, 28.05.2025
https://doi.org/10.53394/akd.1466607

Abstract

Objective: Lagophthalmos is defined as the inability of the eyelids to close completely. This condition can lead to corneal problems such as epithelial defects, corneal ulceration, exposure keratitis, bacterial infection, perforation, and blindness. One of the static treatments for lagophthalmos is the placement of gold implants in the eyelid.
Material and Methods: Retrospectively, all 18 patients who received gold implants in the upper eyelid due to lagophthalmos were included in the study, and their medical records were reviewed.
Results: The average age of the patients was 45.4 years (7 to 72). The male/female ratio was observed as 11/7. The most common cause of lagophthalmos in our cases was intracranial mass (38.8%), followed by congenital facial paralysis, Bell's palsy, and traffic accidents. The average weight of the gold implant was 1.56 g and ranged from 1.3 to 1.8 g. The median follow-up time was 68.5 months (17 to 131). 17 of 18 patients were satisfied with the outcome of the operation and adequate valve closure was achieved at their final follow-up, including patients who underwent reimplantation after extruded implant.
Conclusions: Although platinum implants have become popular today, we think that upper-lid weight application with gold implants is an effective and reliable way to treat lagophthalmos with acceptable morbidities.

References

  • 1. Bianchi B, Ferri A, Leporati M, Ferrari S, Lanfranco D, Ferri T, Sesenna E. Upper eyelid platinum chain placement for treating paralytic lagophthalmos. Journal of Cranio-Maxillofacial Surgery 2014; 42(8):2045-8.
  • 2. Aggarwal E, Naik MN, Honavar SG. Effectiveness of the gold weight trial procedure in predicting the ideal weight for lid loading in facial palsy: a prospective study. Am J Ophthalmol 2007; 143(6):1009-12.
  • 3. Karadeniz Uğurlu Ş, Karakaş M. Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy. Turk J Ophthalmol 2017; 47(3):149-55.
  • 4. Wagh V, Lim W, Cascone N, Morley A. Post-septal upper eyelid loading for treatment of exposure keratopathy secondary to non-cicatricial lagophthalmos Orbit 2016; 35:1-6.
  • 5. Siah WF, Nagendran S, Tan P, Ali Ahmad SM, Litwin AS, Malhotra R. Late outcomes of gold weights and platinum chains for upper eyelid loading. Br J Ophthalmol 2018; 102(2):164-8.
  • 6. Malik A, Joshi N. Gold in the balance: How does patient posture affect eyelid closure? Orbit 2017; 36(5):347-9.
  • 7. Sheehan JE. Progress in correction of facial palsy with tantalum wire and mesh. Surgery 1950; 27(1):122-5.
  • 8. Bergeron CM, Moe KS. The evaluation and treatment of upper eyelid paralysis. Facial Plast Surg 2008; 24(2):220-30.
  • 9. Nazzi V, Marras C, Broggi G. Upper eyelid gold weight implants in patients with facial nerve palsy. Surgical technique. J Neurosurg Sci 2006; 50(4):107-10.
  • 10. Lavy JA, East CA, Bamber A, Andrews PJ. Gold weight implants in the management of lagophthalmos in facial palsy. Clin Otolaryngol Allied Sci 2004; 29(3):279-83.
  • 11. Rozen S, Lehrman C. Upper eyelid postseptal weight placement for treatment of paralytic lagophthalmos. Plast Reconstr Surg 2013; 131(6):1253-65.
  • 12. Illig KM. [A new method of lagophthalmos surgery]. Klin Monbl Augenheilkd Augenarztl Fortbild 1958; 132(3):410-1.
  • 13. Jobe RP. A technique for lid loading in the management of the lagophthalmos of facial palsy. Plast Reconstr Surg 1974; 53(1):29-32.
  • 14. Tower RN, Dailey RA. Gold weight implantation: a better way? Ophthalmic Plast Reconstr Surg 2004; 20(3):202-6.
  • 15. Bladen JC, Norris JH, Malhotra R. Cosmetic comparison of gold weight and platinum chain insertion in primary upper eyelid loading for lagophthalmos. Ophthalmic Plast Reconstr Surg 2012; 28(3):171-5.
  • 16. Razfar A, Afifi AM, Manders EK, Myers EN, Johnson JT, Ferris RL, Deleyiannis FW. Ocular outcomes after gold weight placement and facial nerve resection. Otolaryngol Head Neck Surg 2009; 140(1):82-5.
  • 17. Rofagha S, Seiff SR. Long-term results for the use of gold eyelid load weights in the management of facial paralysis. Plast Reconstr Surg 2010; 125(1):142-9.
  • 18. Malhotra R, Ziahosseini K, Poitelea C, Litwin A, Sagili S. Platinum segments: a new platinum chain for adjustable upper eyelid loading. Br J Ophthalmol 2015; 99(12):1680-5.

Lagoftalmus Tedavisinde Kişiye Özel Altın İmplant Deneyimleri

Year 2025, Volume: 11 Issue: 2, 239 - 244, 28.05.2025
https://doi.org/10.53394/akd.1466607

Abstract

Amaç: Lagoftalmi, göz kapaklarının tam olarak kapanamaması olarak tanımlanır. Bu durum epitel defektleri, korneal ülserasyon, maruz kalma keratiti, bakteriyel enfeksiyon, perforasyon ve körlük gibi kornea sorunlarına yol açabilir. Lagoftalminin statik tedavilerinden birisi göz kapağına altın implant yerleştirilmesidir.
Gereç ve Yöntemler: Retrospektif olarak; lagoftalmi nedeniyle üst göz kapağına altın implant uygulanan 18 hastanın tümü çalışmaya dahil edildi ve medikal kayıtları incelendi.
Bulgular: Hastaların ortalama yaşı 45,4 yıl (7-72) idi. Erkek / kadın oranı 11/7 olarak izlendi. Lagoftalminin en yaygın nedeni olgularımızda intrakraniyal kitleydi (% 38,8) ve konjenital yüz felci, Bell’s felci, trafik kazası izledi. Altın implantın ortalama ağırlığı 1,56 gr ve 1,3-1,8 gr aralığındaydı. Ortalama takip süresi 68,5 ay (17-131) idi. On sekiz hastadan 17'si operasyonun sonucundan memnun kaldı ve ekstrüde implant sonrası reimplantasyon yapılan hastalar da dahil olmak üzere, son takiplerinde yeterli kapak kapatılması sağlandı.
Sonuç: Her ne kadar günümüzde platin implantlar popülarize olmaya başlamışsa da, altın implant ile üst kapak ağırlık uygulamalarının lagoftalmi tedavisinde kabul edilebilir morbiditeler ile etkili ve güvenilir bir yol olduğunu düşünüyoruz.

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References

  • 1. Bianchi B, Ferri A, Leporati M, Ferrari S, Lanfranco D, Ferri T, Sesenna E. Upper eyelid platinum chain placement for treating paralytic lagophthalmos. Journal of Cranio-Maxillofacial Surgery 2014; 42(8):2045-8.
  • 2. Aggarwal E, Naik MN, Honavar SG. Effectiveness of the gold weight trial procedure in predicting the ideal weight for lid loading in facial palsy: a prospective study. Am J Ophthalmol 2007; 143(6):1009-12.
  • 3. Karadeniz Uğurlu Ş, Karakaş M. Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy. Turk J Ophthalmol 2017; 47(3):149-55.
  • 4. Wagh V, Lim W, Cascone N, Morley A. Post-septal upper eyelid loading for treatment of exposure keratopathy secondary to non-cicatricial lagophthalmos Orbit 2016; 35:1-6.
  • 5. Siah WF, Nagendran S, Tan P, Ali Ahmad SM, Litwin AS, Malhotra R. Late outcomes of gold weights and platinum chains for upper eyelid loading. Br J Ophthalmol 2018; 102(2):164-8.
  • 6. Malik A, Joshi N. Gold in the balance: How does patient posture affect eyelid closure? Orbit 2017; 36(5):347-9.
  • 7. Sheehan JE. Progress in correction of facial palsy with tantalum wire and mesh. Surgery 1950; 27(1):122-5.
  • 8. Bergeron CM, Moe KS. The evaluation and treatment of upper eyelid paralysis. Facial Plast Surg 2008; 24(2):220-30.
  • 9. Nazzi V, Marras C, Broggi G. Upper eyelid gold weight implants in patients with facial nerve palsy. Surgical technique. J Neurosurg Sci 2006; 50(4):107-10.
  • 10. Lavy JA, East CA, Bamber A, Andrews PJ. Gold weight implants in the management of lagophthalmos in facial palsy. Clin Otolaryngol Allied Sci 2004; 29(3):279-83.
  • 11. Rozen S, Lehrman C. Upper eyelid postseptal weight placement for treatment of paralytic lagophthalmos. Plast Reconstr Surg 2013; 131(6):1253-65.
  • 12. Illig KM. [A new method of lagophthalmos surgery]. Klin Monbl Augenheilkd Augenarztl Fortbild 1958; 132(3):410-1.
  • 13. Jobe RP. A technique for lid loading in the management of the lagophthalmos of facial palsy. Plast Reconstr Surg 1974; 53(1):29-32.
  • 14. Tower RN, Dailey RA. Gold weight implantation: a better way? Ophthalmic Plast Reconstr Surg 2004; 20(3):202-6.
  • 15. Bladen JC, Norris JH, Malhotra R. Cosmetic comparison of gold weight and platinum chain insertion in primary upper eyelid loading for lagophthalmos. Ophthalmic Plast Reconstr Surg 2012; 28(3):171-5.
  • 16. Razfar A, Afifi AM, Manders EK, Myers EN, Johnson JT, Ferris RL, Deleyiannis FW. Ocular outcomes after gold weight placement and facial nerve resection. Otolaryngol Head Neck Surg 2009; 140(1):82-5.
  • 17. Rofagha S, Seiff SR. Long-term results for the use of gold eyelid load weights in the management of facial paralysis. Plast Reconstr Surg 2010; 125(1):142-9.
  • 18. Malhotra R, Ziahosseini K, Poitelea C, Litwin A, Sagili S. Platinum segments: a new platinum chain for adjustable upper eyelid loading. Br J Ophthalmol 2015; 99(12):1680-5.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Plastic Reconstructive and Aesthetic Surgery, Vision Science
Journal Section Research Article
Authors

Ahmet Demir 0000-0002-8820-3122

Mehmet Berke Göztepe 0000-0002-1193-3696

Engin Selamioğlu 0000-0002-3744-9325

Early Pub Date May 22, 2025
Publication Date May 28, 2025
Submission Date April 7, 2024
Acceptance Date September 5, 2024
Published in Issue Year 2025 Volume: 11 Issue: 2

Cite

Vancouver Demir A, Göztepe MB, Selamioğlu E. Lagoftalmus Tedavisinde Kişiye Özel Altın İmplant Deneyimleri. Akd Med J. 2025;11(2):239-44.