Abstract
Chepeha DB, Yoo J, Birt C, Gilbert RW, Chen J
Arch Otolaryngol Head Neck Surg
. 2001;127:299-300
Objectives:
To assess which signs and symptoms were relieved by gold weight implantation and which signs and symptoms persisted.
Design:
Prospective observational cohort.
Setting:
Tertiary care neurotology and oncology center.
Patients:
Sixteen (4 males and 12 females) consecutive patients whose average age was 56 years (age range, 31-76 years). Inclusion criteria were gold weight implant, lagophthalmus of 2 mm or more, and a House-Brackmann score of 3 or less at the completion of follow-up. Mean follow-up was 13 months.
Interventions:
Each patient received a gold weight implant. Six of these patients underwent a lower eyelid procedure.
Main Outcome Measures:
Surgical complications, static and dynamic lagophthalmus, static and dynamic corneal coverage, visual acuity, keratitis, topical treatment, and patient satisfaction.
Results:
There were no extrusions. The preoperative mean lagophthalmus was 7.5 mm and the postoperative mean was 0.5 mm (P<.001). Corneal coverage with eye closure before implantation was 73% and after implantation was 100% (P<.001). Corneal coverage with normal (reflex) blink was less than 50% in 9 of 14 patients. When wearing correction, no patients had 20/20 visual acuity. The mean patient satisfaction score before the procedure was 3.5 and after was 7.1 (P<.001). Patient satisfaction was most closely related to visual acuity. The relationship was linear and statistically significant (P<.04).
Conclusion:
Gold weight implantation provides significant reduction in lagophthalmus and significant improvement in corneal coverage. But owing to delayed closure time and disrupted tear film, irritation may persist. As a result, some patients require ongoing topical treatment of the eye, which can compromise visual acuity.
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