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Secondary Eyelid Weight Surgery in Patients with Facial Paralysis
Charles M Henry1, Haley M Hullfish1, Chloe Mattila2
1Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Summary
Facial paralysis patients needing eyelid weight revision surgery often require it due to nerve function recovery or implant issues. Understanding these factors aids in managing paralytic lagophthalmos.
Area of Science:
- Ophthalmology
- Facial Plastic Surgery
- Neurology
Background:
- Paralytic lagophthalmos from facial paralysis causes exposure keratopathy and corneal damage.
- Upper eyelid weight implantation improves passive eyelid closure and corneal protection.
- Secondary surgery for eyelid weights is sometimes needed, but revision factors are unclear.
Purpose of the Study:
- To identify clinical and surgical factors associated with secondary eyelid weight surgery (replacement or removal).
- To analyze reasons for revision surgery in patients with facial paralysis.
Main Methods:
- Retrospective chart review of patients undergoing eyelid weight placement for unilateral facial paralysis (2014-2023).
- Data included demographics, paralysis etiology, radiation history, paralysis recovery, and implant details.
- Statistical analysis compared factors associated with secondary surgery and revision types.
Main Results:
- 22.3% of patients (21/94) required secondary surgery.
- Top reasons for revision: facial nerve function recovery (33.3%), bothersome symptoms (28.6%), extrusion (23.8%), and persistent incomplete eye closure (14.3%).
- Partial/complete paralysis recovery significantly increased likelihood of secondary surgery (61.8% vs 22%; p < 0.001).
Conclusions:
- Secondary eyelid weight surgery is mainly linked to facial function recovery.
- Persistent ocular symptoms and implant extrusion are other significant drivers for revision.
- Eyelid weight revision factors are crucial for optimizing patient outcomes in facial paralysis.
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