The British journal of ophthalmology · 2015
Platinum segments: a new platinum chain for adjustable upper eyelid loading.
СтатьяНазвание и аннотация: Перевод в очереди
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Malhotra Raman, Ziahosseini Kimia, Poitelea Cornelia, Litwin Andre, Sagili Suresh
Аннотация
PURPOSE: Prospective study evaluating outcomes of individually sutured platinum segment chains in upper eyelid loading.
METHODS: Single-centre, single-surgeon, prospective study. Upper eyelid loading with 0.4 and 0.2 g platinum segment chains for lagophthalmos. Segments were sutured to create a desired weight and attached to superior tarsus and distal levator aponeurosis following levator recession.
PRIMARY OUTCOME MEASURES: improvement in lagophthalmos and complications.
SECONDARY OUTCOME MEASURES: cosmesis of eyelid margin contour and implant prominence. Minimum 3-month follow-up.
RESULTS: Eighteen eyelids of 17 patients received segment chains (mean weight 1.2 g, range 0.8-1.6 g) and 3 for exchange of pre-existing gold weights. Median follow-up was 10 (range 6-17) months. Mean blink lagophthalmos improved from 7 (3-10) mm to 3 (0-6) mm (p<0.0001), and gentle closure from 3.2 (0-8) mm to 1.1 (0-4.9) mm (p=0.0004). Twelve patients (71%) reported no prominence, and the remainder, mild prominence only. The chain was graded as having no prominence in 78% (14/18) eyelids. Two required segment adjustments with removal of a single 0.2 g segment at 11 months and transfer of 0.4 g segment to the contralateral eyelid at 16 months, respectively. One complication (posterior, trans-conjunctival exposure above the superior border of the tarsal plate) was seen 12 months post surgery, requiring repositioning.
CONCLUSIONS: Platinum segment chains provide benefits of platinum chains with additional advantages of postoperative adjustibility. They can be used as an addition to pre-existing in situ weights or chains.
TRIAL REGISTRATION NUMBER: REC reference: 13/SW/0146. IRAS project ID: 119022.
METHODS: Single-centre, single-surgeon, prospective study. Upper eyelid loading with 0.4 and 0.2 g platinum segment chains for lagophthalmos. Segments were sutured to create a desired weight and attached to superior tarsus and distal levator aponeurosis following levator recession.
PRIMARY OUTCOME MEASURES: improvement in lagophthalmos and complications.
SECONDARY OUTCOME MEASURES: cosmesis of eyelid margin contour and implant prominence. Minimum 3-month follow-up.
RESULTS: Eighteen eyelids of 17 patients received segment chains (mean weight 1.2 g, range 0.8-1.6 g) and 3 for exchange of pre-existing gold weights. Median follow-up was 10 (range 6-17) months. Mean blink lagophthalmos improved from 7 (3-10) mm to 3 (0-6) mm (p<0.0001), and gentle closure from 3.2 (0-8) mm to 1.1 (0-4.9) mm (p=0.0004). Twelve patients (71%) reported no prominence, and the remainder, mild prominence only. The chain was graded as having no prominence in 78% (14/18) eyelids. Two required segment adjustments with removal of a single 0.2 g segment at 11 months and transfer of 0.4 g segment to the contralateral eyelid at 16 months, respectively. One complication (posterior, trans-conjunctival exposure above the superior border of the tarsal plate) was seen 12 months post surgery, requiring repositioning.
CONCLUSIONS: Platinum segment chains provide benefits of platinum chains with additional advantages of postoperative adjustibility. They can be used as an addition to pre-existing in situ weights or chains.
TRIAL REGISTRATION NUMBER: REC reference: 13/SW/0146. IRAS project ID: 119022.