[Pretarsal platinum-iridium implants for therapy of lagophthalmos in facial paralysis. Preliminary results].

UNLABELLED: Upper lid closure in facial nerve paresis induced lagophthalmos is often improved by implantation of gold weights. However, the tolerability of gold implants has not always met expectations. We therefore investigated whether results could be improved by implantation of well-tolerated platinum implants.

PATIENTS AND

METHODS

Three patients with lagophthalmos received pretarsal platinum-iridium implants in the upper lid. The implants were primary in two patients and secondary in one. In this patient, the previous gold implant had led to marked swelling and redness of the upper lid 6 weeks after surgery. The platinum implants were prefabricated with a radius of 20 mm and weighed between 1.3 and 1.4 g. During implantation, they were individually contoured to fit lidcurvature and attached pretarsally with nonresorbable thread.

RESULTS

Postoperatively, the upper lid of all three patients could be closed completely. The implants healed without irritation. No lid swelling occurred during 2-to 6-month follow-up. Because platinum-iridium alloys have a higher specific gravity (Ptlr 90/10 = 21.65 g/cm3) than gold (18.43 g/cm3), they can attain equal weight at smaller size.

CONCLUSIONS

Our first results show that platinum implants are a feasible alternative to gold implants in treating lagophthalmos due to better biocompatibility and higher specific gravity.