Platinum segments: a new platinum chain for adjustable upper eyelid loading

Area of Science:

• Ophthalmology
• Reconstructive Surgery

Background:

• Lagophthalmos, the inability to close the eyelids, can lead to ocular surface disease.
• Eyelid loading with weights is a common treatment to improve eyelid closure.
• Platinum segment chains offer a novel approach to adjustable eyelid loading.

Purpose of the Study:

• To evaluate the outcomes of individually sutured platinum segment chains for upper eyelid loading in patients with lagophthalmos.

Main Methods:

• A prospective, single-centre study involving upper eyelid loading with platinum segment chains (0.4g and 0.2g).
• Segments were sutured to achieve desired weight and attached to the superior tarsus and distal levator aponeurosis.
• Outcomes included improvement in lagophthalmos and assessment of complications, cosmesis, and implant prominence with a minimum 3-month follow-up.

Main Results:

• Eighteen eyelids in 17 patients received platinum segment chains, with a mean weight of 1.2g.
• Significant improvement in blink lagophthalmos (7mm to 3mm, p<0.0001) and gentle closure (3.2mm to 1.1mm, p=0.0004) was observed.
• 71% of patients reported no prominence, and 78% of eyelids had no visible chain prominence. One complication required repositioning.

Conclusions:

• Individually sutured platinum segment chains are a safe and effective treatment for lagophthalmos.
• These chains offer the benefits of platinum with enhanced postoperative adjustability.
• They can be used as an adjunct to existing eyelid weights or chains.