D B Chepeha1, J Yoo, C Birt, R W Gilbert, J Chen. 1. University of Michigan, Department of Otolaryngology, 1904 Taubman Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0312, USA. dchepeha@umich.edu
Abstract
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, lagophthalmos 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 lagophthalmos, static and dynamic corneal coverage, visual acuity, keratitis, topical treatment, and patient satisfaction. RESULTS: There were no extrusions. The preoperative mean lagophthalmos 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). CONCLUSIONS: Gold weight implantation provides significant reduction in lagophthalmos 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.
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, lagophthalmos 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 lagophthalmos, static and dynamic corneal coverage, visual acuity, keratitis, topical treatment, and patient satisfaction. RESULTS: There were no extrusions. The preoperative mean lagophthalmos 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). CONCLUSIONS: Gold weight implantation provides significant reduction in lagophthalmos 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.
Authors: Ioannis Mavrikakis; Efstathios T Detorakis; Stefanos Baltatzis; Ioannis Yiotakis; Dimitrios Kandiloros Journal: Med Hypothesis Discov Innov Ophthalmol Date: 2015