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

Raman Malhotra1, Kimia Ziahosseini1, Cornelia Poitelea1

  • 1Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.

The British Journal of Ophthalmology
|May 20, 2015
PubMed
Summary

Individually sutured platinum segment chains effectively treat upper eyelid lagophthalmos, offering adjustability and good cosmetic outcomes. This method improves eyelid closure with minimal complications.

Keywords:
Eye LidsRehabilitationTreatment Surgery

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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.