Upper lid loading with gold weights in paralytic lagophthalmos: A modified technique to maximize the long-term functional and cosmetic success

Abstract

PURPOSE To describe a modified fixation technique to improve the long-term functional and cosmetic success of upper lid loading with gold weights. METHOD A retrospective single surgeon study of combined upper pre-tarsal and direct levator fixation of the gold weight. The minimum follow-up period was 12 months. RESULTS Gold weights were implanted with the modified technique into 29 patients. The gold weight was removed in two cases due to infection and in one case due to ptosis. There was no loss of function over the follow-up period and the cosmetic outcome was good or very good in all cases. The follow-up ranged from 12 to 84 months with a mean of 40 months. CONCLUSIONS Combined upper pre-tarsal fixation and direct levator fixation is effective in maximizing both the long-term functional and cosmetic success of upper lid loading with gold weights in paralytic lagophthalmos.