ADHESIVE LID WEIGHTS (REVERSIBLE LIDLOADI NG) FOR TREATMENT OF LAGOPHTHALMOS

Background In facial palsies with lagophthalmic keratopathy an hour-gl ass dressing is indicated, which has the disadvantage of a moisture ch amber with visual impairment by steaming up. After weeks of placement dermal irritations are possible. An alternative is the gravity depend ent lidloading, using gold implantation in cases of irreversible lagop hthalmos. Methods and patients Lead weights of 0.8 to 2.0 g are glued to the upper lid with an adhesive layer, that is well tolerated by the skin (Combihesive''), or by a simple foil that is glued on both sides (Tesafix). This results in a lid-closure without impairment of lid op ening. After tests on 10 normal persons the described method was place d on 22 patients with lagophthalmos and compared with hour-glass dress ing. The new method was applied to 36 additional patients.Results The dynamic lead weight is effective and well-tolerated. It was more accep ted cosmetically especially during the day because of better cosmetic appearance and better visual function than was the hour-glass dressing . These latter dressings are still important for use in serious cases during the night. Conclusion lidloading with lead weights that are glu ed by an adhesive layer to the upper lid can be recommended as a new m ethod in cases of reversible lagophthalmos or as a preparatory step be fore gold implantation.