Induced corneal astigmatism by palpebral spring for the treatment of lagophthalmos.

PURPOSE: To report a patient with decreased vision after insertion of an upper eyelid palpebral spring.

METHODS

Interventional case report.

RESULTS

A 44-year-old man presented with decreased vision in his right eye. Several months before presentation, he underwent palpebral spring insertion in his upper eyelid for lagophthalmos. He had developed seventh cranial nerve palsy after removal of the right facial nerve neuroma. Decreased vision was related to induced astigmatism by upper eyelid pressure. Surgical replacement of the spring resulted in less astigmatism and improvement in visual acuity.

CONCLUSIONS

Ocular rehabilitation surgery with insertion of a palpebral spring to the upper eyelid may induce corneal astigmatism and decrease vision in the normal eye. This may be reversible by replacing or repositioning the spring so that it will imply less corneal pressure.