NEW METHOD FOR TREATMENT OF LAGOPHTHALMOS IN REVERSIBLE FACIAL PALSY

Background: For prophylaxis or therapy of lagophthalmic keratopathy oi ntment application or hour glass dressing is indicated. The hour glass dressing has the disadvantage of a continuous visual impairment by st eaming up of the moisture chamber. The main problem for the patients i s the strong subjective feeling of physical handicap. A therapeutic al ternative is the gravity dependent lidloading, which is known as gold implantation in cases of irreversible lagophthalmos. Methods and patie nts: By lead weights of 0,8 to 2,0 g, which are fixed to the upper lid by a foil glueing on both sides (Tesafix) or in allergic patients by an adhesive layer, well tolerated by the skin (Combihesive), the lidcl osure can become restored without impairment of lid-opening, In a cont rolled study the described method was first tested on 10 normal person s and than applied to 22 patients with lagophthalmos, Meanwhile the ne w method was applied to 32 further patients. Results: The ''liddynamic '' procedure is effective and well tolerated; it is more accepted, esp ecially during the day, because of better visual function and better c osmetics. The hour glass dressing, is still of importance in serious c ases of kerathopathy during the night. Conclusion: ''lidloading'' with lead weights, which are glued by an adhesive layer to the upper lid, can be recommended as a new method in cases of reversible lagophthalmo s or as a preparing step before a gold implantation.