Weight measurement of upper eyelid gold implants for lagophthalmos in facial paralysis

The use of the gold weight is an established procedure in the treatment of lagophthalmos and usually produces successful results. The critical technical issues are the firm suture fixation to the tarsal plate and the high location of the weight on this plate. However, the estimated weight of the implant from the trials on the skin of the upper lid fails to obtain the expected eye closure outcomes after surgical implantation on the tarsal plate. One of the main reasons could be the different curvature on the skin and on the tarsal plate of the upper eyelid. In this study, the angles between the vertical line and the surface of the outer (skin) and inner (tarsal plate) part of the upper eyelid have been analyzed when the eye is opened and closed. The results show that an addition of 0.2 g to the gold weight estimated in the trial is required to achieve a similar closure of the eye by means of the gold implant on the tarsal plate.