Positional lagophthalmos variability in facial nerve palsy with and without upper eyelid loading

Area of Science:

• Ophthalmology
• Facial Nerve Surgery
• Biomedical Engineering

Background:

• Lagophthalmos, a condition resulting from facial nerve palsy, affects eyelid closure.
• Traditional measurement of lagophthalmos in an upright position may not capture positional variations.
• Understanding positional effects is vital for accurate assessment and management of paralytic lagophthalmos.

Purpose of the Study:

• To evaluate the impact of body position on lagophthalmos measurements.
• To assess how surgical techniques, implant materials, and patient demographics influence lagophthalmos.
• To identify optimal measurement positions and implant choices for managing paralytic lagophthalmos.

Main Methods:

• A multicenter prospective study involving 64 eyelids.
• Evaluation of positional changes in lagophthalmos from sitting to supine.
• Analysis of factors including upper eyelid weight implantation, implant material (gold vs. platinum), and patient demographics.

Main Results:

• Lagophthalmos increased by a mean of 1.4 mm when moving from sitting to supine position (p < 0.001).
• Eyelid weight implantation led to greater lagophthalmos variability compared to no implantation (p = 0.047).
• Platinum weights showed less positional variability than gold weights (p = 0.026).

Conclusions:

• Routine measurement of lagophthalmos in the supine position is recommended to identify nocturnal exposure risks.
• Platinum eyelid weights may be preferable to gold weights due to reduced positional variability.
• Findings guide surgical choices and patient management for paralytic lagophthalmos.