Lid retraction in endocrine orbitopathy. A new indication for "lid loading"

Lid retraction in thyroid ophthalmopathy may lead to cosmetic and functiona l problems. Many surgical procedures are available to correct upper lid ret raction. Only those procedures should be used that lead either to a limited lid lengthening or can be reversed in cases with complications. Upper lid gold weight implantation was first used to treat lagophthalmos in patients with facial palsy. Since 1995 only a few reports have appeared which discus s plantinum as an implantation material. We report our experiences with a f emale patient who developed an upper lid retraction due to thyroid ophthalm opathy. Through implantation of a platinum weight which was adjusted exactl y preoperatively, a symmetric palpebral fissure was achieved. Unilateral up per lid retraction with resultant eyelid asymmetry is a new indication for lid loading.