The use of gold weight in facial palsy lagophthalmos

Peripheral facial paralysis is often accompanied by incomplete closure of t he lid. In the past, tarsorrhaphy has been the primary method for achieving improved eyelid closure, but it has functional and cosmetic drawbacks. As an alternative, a gold weight implant has been used for closure of the uppe r lid by gravity and, if necessary, can be combined with further rehabilita tive facial surgery. A total of 36 patients with peripheral facial paresis were treated with gold weight upper lid im plants. Postoperative closure of the lids was sufficient in all cases. Complications were observed, such as pseudoptosis, deficiency of eyelid closure, a prominent bulge of the gold implant, in one case frank extrusion of the gold implant, and, surprisingly , in several cases the formation of a low grade corneal astigmatism. The sa tisfactory functional results show that the implant is both aesthetically a nd functionally superior to tarsorrhaphy.