Use of isobutyl cyanoacrylate tissue adhesive to stabilize external eyelidweights in temporary treatment of facial palsies

Purpose: To describe a technique for stabilizing external eyelid load weigh ts with isobutyl cyanoacrylate tissue adhesive for the temporary treatment of facial palsies. Methods: This was a nonrandomized, prospective study of six consecutive pat ients with unilateral facial paralysis treated with external eyelid load we ights stabilized with isobutyl cyanoacrylate tissue adhesive instead of adh esive tape. Follow-up assessment included corneal exposure, patient comfort , amount of artificial tear usage, and complications associated with the we ights. Results: Of the six patients studied, five had decreased corneal exposure, decreased artificial tear usage, and increased patient comfort with use of the weights. One patient had no improvement of symptoms. Weights were retai ned for a mean of 10.7 days. Two patients had difficulty with the weights; one was secondary to dermatochalasis and blepharoptosis obscuring his visio n, and the other patient's weight fell off after 1 day. No weights were los t. Conclusions: The use of isobutyl cyanoacrylate tissue adhesive is a simple, quick, and inexpensive method for placement of external eyelid weights for temporary treatment of ocular exposure associated with facial paralysis an d for determining the correct weight for implantation. Furthermore, isobuty l cyanoacrylate tissue adhesive used to stabilize external eyelid weights i s better tolerated and lasts longer than the previously described fixation method with adhesive tape.