Eyelid Implants in Lagophtalmus Therapy

Authors: M. Odehnal;  J. Malec;  I. Malcová;  D. Dotřelová
Authors‘ workplace: Oční klinika dětí a dospělých 2. LF UK a FN v Motole, Praha
Published in: Cesk Slov Neurol N 2011; 74/107(4): 459-462
Category: Short Communication


The authors report their experience with eyelid surgical implants, applied in lagophtalmus therapy of facial nerve palsy. A total of 29 patients (three of them children) were opera­ted upon during the period between 2004 and 2010 at the Eye Clinic for Children and Adults (Prague, Motol Hospital). Progressive corneal keratopathy was the main indication for operation. The average follow-up period was 4.5 years. The eyelid surgical implants were made of pure gold. Eyelid function before and after surgery was evaluated in terms of the House-Brackmann scale. Eyelid function improved in all patients and corneal keratopathy improved in 75% of them. Lagophtalmus was reduced from an average diameter of 6.5 mm (4.5–9.5 mm) before operation to an average diameter of 1.5 mm (0–2.5 mm) after ope­ration. Twenty-seven of the patients operated upon considered that eyelid surgery had improved their quality of life.

Key words:
facial nerve palsy – lagophtalmus – eyelid surgical implant – gold implant


1. Cline D, Hofstetter HW, Griffin JR. Dictionary of visual science. 4th ed. Boston: Butterworth-Heinemann 1997.

2. Rubin LR, Lee GW, Simpson RL. Reanimation of the long-standing partial facial paralysis. Plast Reconstr Surg 1986; 77(1): 41–49.

3. Smellie GD. Restoration of the blinking reflex in facial palsy by a simple lid-load operation. Br J Plast Surg 1966; 19(3): 279–283.

4. Odehnal M, Malec J, Dotrelova D. The first experience with gold eyelid implants in facial nerve palsies. Cesk Slov Oftalmol 2008; 64(3): 95–99.

5. Kao CH, Moe KS. Retrograde weight implantation for correction of lagophthalmos. Laryngoscope 2004; 114(9): 1570–1575.

6. Snyder MC, Johnson PJ, Moore GF, Ogren FP. Early versus late gold weight implantation for rehabilitation of the paralyzed eyelid. Laryngoscope 2001; 111(12): 2109–2113.

7. Choi M, Driscoll CF. Fabrication of a custom eyelid implant prosthesis: a clinical report. J Prosthodont 2004; 13(2): 101–103.

8. Grisius MM, Hof RL. Treatment of lagophthalmos of the eye with a custom prosthesis. J Prosthet Dent 1993; 70(4): 333–335.

9. Mavrikakis I, Beckingsale P, Lee E, Riaz Y, Brittain P. Changes in corneal topography with upper eyelid gold weight implants. Ophthal Plast Reconstr Surg 2006; 22(5): 331–334.

10. Aggarwal E, Naik MN, Honavar SG. Effectiveness of the gold weight trial procedure in predicting the ideal weight for lid loading in facial palsy: a prospective study. Am J Ophthalmol 2007; 143(6): 1009–1012.

11. Dinces EA, Mauriello JA jr, Kwartler JA, Franklin M. Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis. Laryngoscope 1997; 107(12): 1617–1622.

12. Dalkiz M, Gokce HS, Aydin A, Beydemir B. Gold weight implantation for rehabilitation of the paralysed eyelid. Int J Oral Maxillofac Surg 2007; 36(6): 522–526.

13. Nazzi V, Marras C, Broggi G. Upper eyelid gold weight implants in patients with facial nerve palsy. Surgical technique. J Neurosurg Sci 2006; 50(4): 107–110.

14. Bair RL, Harris GJ, Lyon DB, Komorowski RA. Noninfectious inflammatory response to gold weight eyelid implants. Ophthal Plast Reconstr Surg 1995; 11(3): 209–214.

15. Bhatti AF, Page K, Orlando A. Modification of the gold-weight implant for insertion into the upper eyelid in facial palsy. Ann Plast Surg 2005; 55(6): 689–692.

16. Kelley SA, Sharpe DT. Gold eyelid weights in patients with facial palsy: a patient review. Plast Reconstr Surg 1992; 89(3): 436–440.

17. Hontanilla B. Weight measurement of upper eyelid gold implants for lagophthalmos in facial paralysis. Plast Reconstr Surg 2001; 108(6): 1539–1543.

Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

2011 Issue 4

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