Multiple gold weight implants to treat lagophthalmos and improve contour

To report a novel approach for managing persistent lagophthalmos and eyelid contour abnormality after initial gold weight implantation.

Paralytic lagophthalmos is defective eyelid closure due to facial nerve damage. One common, effective treatment is lid loading with eyelid weights. By implanting a weight into the upper eyelid, gravity is used to help close the eyelid, decrease corneal exposure, and prevent further disease such as exposure keratopathy. This case details a patient with paralytic lagophthalmos post resection of a vestibular schwannoma. She underwent gold weight implantation but still experienced incomplete eyelid closure and altered eyelid contour. Instead of performing common revision procedures such as repositioning or replacing the weight, a second, smaller, gold weight was added in the same eyelid.

Placement of a second gold weight in the same eyelid may represent a simple alternative to revision and replacement of initial gold weight.