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Related Experiment Videos

Type IV hypersensitivity reactions to upper lid gold weight implants-is patch testing necessary?

E Doyle1, I Mavrikakis, E J Lee

  • 1Sussex Eye Hospital, Brighton and Sussex University Hospitals, Brighton, East Sussex, U.K. EdRachie@btinternet.com

Orbit (Amsterdam, Netherlands)
|September 20, 2005
PubMed
Summary

Allergic reactions to upper eyelid gold implants can occur. Pre-implantation patch testing can help predict gold hypersensitivity in patients with a history of gold allergy or dental work.

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Area of Science:

  • Ophthalmology
  • Allergology
  • Materials Science

Background:

  • Upper eyelid gold weight implants are used to treat facial nerve palsy-induced lagophthalmos.
  • Allergic reactions to gold implants, though rare, can necessitate removal and alternative treatments.

Observation:

  • Two cases of allergic reactions to upper eyelid gold weight implants are reported.
  • One patient with a history of gold allergy and dental work showed a positive patch test to gold sodium thiosulphate.
  • Histological examination of tissue from the second patient indicated type IV hypersensitivity.

Findings:

  • Patch testing can identify patients hypersensitive to gold before implantation.
  • The purity of the gold implant (99.99%) suggests direct gold sensitivity, not impurities, caused the reaction.

Related Experiment Videos

  • Histopathology confirmed hypersensitivity as the cause of the inflammatory reaction.

    • Implications:

    • Pre-implantation screening for gold allergy is crucial, especially with personal or family history.
    • Patch testing is recommended for patients with prior gold exposure or uncertain allergy history.
    • Identifying gold hypersensitivity allows for alternative treatment strategies to prevent implant-related complications.