[Lid retraction in endocrine orbitopathy. A new indication for "lid loading"]

Area of Science:

• Ophthalmology
• Endocrinology
• Plastic Surgery

Background:

• Thyroid ophthalmopathy frequently causes upper eyelid retraction, leading to significant cosmetic and functional impairments.
• Surgical correction of upper eyelid retraction aims for limited lengthening or reversibility due to potential complications.
• While gold weights have been used for lagophthalmos, platinum as an implantation material for eyelid retraction is less documented.

Observation:

• A female patient with unilateral upper eyelid retraction secondary to thyroid ophthalmopathy presented with eyelid asymmetry.
• Preoperative adjustment and intraoperative implantation of a platinum upper eyelid weight were performed.
• The procedure resulted in a symmetric palpebral fissure, effectively addressing the asymmetry.

Findings:

• Platinum upper eyelid weight implantation is a viable surgical option for correcting unilateral upper eyelid retraction in thyroid ophthalmopathy.
• The use of platinum offers a potentially reversible method for lid loading, addressing asymmetry and functional deficits.
• This case highlights a novel indication for upper lid loading procedures.

Implications:

• Platinum eyelid weights provide a precise and adjustable solution for eyelid asymmetry in thyroid eye disease.
• This technique expands surgical options for managing the functional and aesthetic consequences of thyroid-related eyelid retraction.
• Further research into platinum's long-term efficacy and safety in lid loading procedures is warranted.