[Treatment of lagophthalmos with adhesive eyelid weights (reversible lid-loading)]

In facial palsies with lagophthalmic keratopathy, an hour-glass dressing is indicated. This dressing has the disadvantage of a moisture chamber, visual impairment occurs by steaming up. After weeks of placement dermal irritations are possible. An alternative is gravity-dependent lid-loading, using gold implantation in cases of irreversible lagophthalmos.

Lead weights of 0.8 to 2.0 g are glued to the upper lid with an adhesive layer that is well-tolerated by the skin (Combihesive*) or by a simple foil that is glued on both sides (Tesafix). This results in a lid closure without impairment of lid opening. After tests on 10 normal persons lid-loading implants were placed on 22 patients with lagophthalmos and compared with hour-glass dressing. The new method was also applied to 26 additional patients.

The dynamic lead weight was effective and well-tolerated. It was more accepted eosine tically, especially during the day because of its better cosmetic appearance and better visual function than was the hour-glass dressing. These latter dressings are still important for use in serious cases during the night.

Lid-loading with lead weights that are glued by an adhesive layer to the upper lid can be recommended as a useful method in cases of reversible lagophthalmos or as a preparatory step before gold implantation.