Kevin E Houston1, Matteo Tomasi2, Michael Yoon3, Eleftherios I Paschalis4. 1. Vision Rehabilitation Laboratory, Department of Ophthalmology, Schepens Eye Research Institute - Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA ; Vision Service, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA. 2. Vision Rehabilitation Laboratory, Department of Ophthalmology, Schepens Eye Research Institute - Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA. 3. Oculoplastic Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA. 4. Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Schepens Eye Research Institute - Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: To test a prototype magnet system (magnetic levator prosthesis) for the ability to comfortably and non-invasively provide eye opening with maintenance of the blink in people with paralytic ptosis and determine preliminary efficacy for short-term clinical application. METHODS: The prototype device consisted of a magnet on a spectacle frame and a micro-magnet array mounted externally on the eyelid. Participants with unilateral CN III palsy (n=3) trialed the predicate (ptosis crutch) and magnet device. Video analysis was used to quantify changes in eyelid opening and subjective responses were documented with a rating scale. A 20-minute and then a 1-week trial were offered. RESULTS: The magnetic levator prosthesis device was effective to provide eye opening while allowing, at minimum, a volitional blink without ill effects on the eyelid skin or ocular surface. Comfort scores ranged from 6 to 9 out of 10 over 3 evaluations. All patients chose an extended trial of the magnet device and reported continued 8-9/10 comfort and efficacy after the extended 1-week trial. CONCLUSIONS: Comfortable and effective restoration of eye opening with maintenance of the blink is feasible using external static magnets and warrants further study. TRANSLATIONAL RELEVANCE: This is the first careful documentation of the successful use of an externally mounted static magnet system to treat paralytic ptosis.
PURPOSE: To test a prototype magnet system (magnetic levator prosthesis) for the ability to comfortably and non-invasively provide eye opening with maintenance of the blink in people with paralytic ptosis and determine preliminary efficacy for short-term clinical application. METHODS: The prototype device consisted of a magnet on a spectacle frame and a micro-magnet array mounted externally on the eyelid. Participants with unilateral CN III palsy (n=3) trialed the predicate (ptosis crutch) and magnet device. Video analysis was used to quantify changes in eyelid opening and subjective responses were documented with a rating scale. A 20-minute and then a 1-week trial were offered. RESULTS: The magnetic levator prosthesis device was effective to provide eye opening while allowing, at minimum, a volitional blink without ill effects on the eyelid skin or ocular surface. Comfort scores ranged from 6 to 9 out of 10 over 3 evaluations. All patients chose an extended trial of the magnet device and reported continued 8-9/10 comfort and efficacy after the extended 1-week trial. CONCLUSIONS: Comfortable and effective restoration of eye opening with maintenance of the blink is feasible using external static magnets and warrants further study. TRANSLATIONAL RELEVANCE: This is the first careful documentation of the successful use of an externally mounted static magnet system to treat paralytic ptosis.
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Authors: Robert A Ganz; Jeffrey H Peters; Santiago Horgan; Willem A Bemelman; Christy M Dunst; Steven A Edmundowicz; John C Lipham; James D Luketich; W Scott Melvin; Brant K Oelschlager; Steven C Schlack-Haerer; C Daniel Smith; Christopher C Smith; Dan Dunn; Paul A Taiganides Journal: N Engl J Med Date: 2013-02-21 Impact factor: 91.245
Authors: Eleftherios I Paschalis; James Chodosh; Ralph A Sperling; Borja Salvador-Culla; Claes Dohlman Journal: PLoS One Date: 2013-06-28 Impact factor: 3.240
Authors: Kevin E Houston; Eleftherios I Paschalis; Danielle C Angueira; P Matthew Bronstad; Anna M Barrett; Mary Alexis Iaccarino Journal: Am J Phys Med Rehabil Date: 2017-04 Impact factor: 2.159
Authors: Kevin E Houston; Matteo Tomasi; Christina Amaral; Nicole Finch; Michael K Yoon; Hang Lee; Eleftherios I Paschalis Journal: Transl Vis Sci Technol Date: 2018-01-19 Impact factor: 3.283