Gold weight implants in the management of paralytic lagophthalmos

Lagophthalmos secondary to facial nerve damage can lead to corneal exposure and eventually blindness. Appropriate management depends on the severity and likely duration of recovery. Upper eyelid gold implants play an important role in the medium and long term management of this condition. The authors report their experience with 16 consecutive patients who underwent gold weight implantation of the upper eyelids for correction of paralytic lagophthalmos and describe their surgical technique. The mean age of the patients was 70 years with a male predominance (M:F=3.2:1). Radical parotidectomy (69%) was the most common reason for the intervention. The mean weight of the implant was 0.95 g. There were no intraoperative or immediate postoperative complications. One implant (6%) was extruded and one patient (6%) had residual lagophthalmos and required a heavier implant. 15 of the 16 patients were satisfied with the outcome and all had adequate lid closure at last follow up.