[Complications after lid loading. Is the platinum chain really effective?]

Numerous studies on the operative therapy for lagophthalmos exist. Reports about postoperative results, however, are rare and most studies include just a small number of patients. Additionally, since 1999a flexible platinum chains has been available as an alternative to the rigid gold implant. The authors are convinced that the platinum chain matches much more the anatomic prerequisites of the upper eye lid. Therefore, the aim of this study was to compare the complication rate of rigid gold implants with that of the flexible platinum chain. To increase the amount of patient data, a statistical meta-analysis after implantation of gold implants and the data form a survey of all surgeons who do implantations of the platinum chain have been compared.

To collect a greater number of patients a survey with focus on postoperative complications has been sent to all colleagues who perform implantations with the flexible platinum chain in patients with paralytic lagophthalmos. Complications included a corneal astigmatism, a migration of the implant, a bulging, an extrusion or an infection. In a further step the statistical comparison between the survey and the results of the meta-analysis about complications after application of rigid gold implants was performed.

Through the survey, data for 212 implantations of the flexible platinum chains could be collected. The comparison showed a statistically significant lower rate of postoperative complications concerning astigmatism, bulging, and postoperative infections in the platinum chain group. Only the postoperative extrusion rates (6.8% after gold implantations and 3.3% after platinum chain implantations) showed no statistically significant difference (p=0.0612). In general, complications occurred in 45.1% of the cases after use of gold implants and in 12.8% after use of the platinum chain, respectively.

Lid loading is a relatively simple and reversible procedure for the operative therapy of lagophthalmos. By using the platinum chain as an implant, postoperative complications can be decreased and thus the effectiveness of the treatment can be enhanced.