Does lagophthalmos change on lying supine after upper eyelid platinum segment chain loading?

Area of Science:

• Ophthalmology
• Neurology

Background:

• Facial nerve palsy (FNP) commonly impairs eyelid closure, leading to lagophthalmos.
• Platinum segment chains (PSC) are used to treat lagophthalmos in FNP patients.
• The efficacy of PSC in supine positions requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of platinum segment chains (PSC) in managing lagophthalmos in patients with facial nerve palsy (FNP) across different positions.
• To determine if patient positioning (seated vs. supine) affects lagophthalmos severity when using PSC.

Main Methods:

• A prospective case series involving 19 patients with FNP who underwent PSC insertion.
• Lagophthalmos was assessed during gentle and forced eyelid closure in seated and various supine positions.
• Measurements were taken with and without head elevation and pillow support.

Main Results:

• Forty percent of eyes showed increased lagophthalmos when supine with gentle closure.
• No statistically significant difference in lagophthalmos was observed between seated and supine positions during gentle closure or blinking.
• Most patients required lubricating ointment, but few experienced morning ocular symptoms; no eyelid taping was needed.

Conclusions:

• Lagophthalmos can increase in the supine position for 40% of patients with FNP using PSC.
• Despite this, there is no statistically significant difference in lagophthalmos between seated and supine positions for gentle closure.
• PSC remains a viable treatment option for lagophthalmos in FNP, with consistent effectiveness across positions.