Open Access
CC BY 4.0 · Arch Plast Surg 2024; 51(02): 163-168
DOI: 10.1055/s-0043-1777287
Pediatric/Craniomilofacial/Head & Neck
Original Article

Implantation of a Newly Designed Supratarsal Gold Weight versus the Traditional Pretarsal Model for the Correction of Long-standing Paralytic Lagophthalmos: A Retrospective Cohort Study

Natthiya Lailaksiri 
1   Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
,
Pawarit Wanichsetakul 
2   Department of Ophthalmology, Faculty of Medicine, Thammasat University, Bangkok, Thailand
,
Preamjit Saonanon 
1   Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Funding None.
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Abstract

Background The study determined to compare the clinical outcomes of traditional gold weight implantation for the correction of paralytic lagophthalmos with those of a newly designed model.

Methods In this retrospective cohort study, we enrolled 30 patients (76% females; average age 60.8 ± 12 years) with facial palsy who underwent implantation of either the traditional pretarsal gold weight (PT group; n = 15) or a new supratarsal model (ST group; n = 15) from May 2014 to April 2019. The main outcome measures were the 12-month postoperative weight prominence, weight migration, improvement of lagophthalmos, upper eyelid contour, and upper eyelid ptosis. The secondary outcome was long-term (24 months) reoperative rate.

Results The new model group had significantly better eyelid contour (risk ratio [RR] 3.16, 95% confidence interval [CI] 1.62–6.15, p = 0.001), less weight prominence (RR 1.74, 95% CI 1.13–2.70, p = 0.013), less weight migration (RR 1.31, 95% CI 1.12–1.54, p = 0.001), and less eyelid ptosis (RR 2.36, 95% CI 1.21–4.59, p = 0.011) than the traditional model group. Improvement of lagophthalmos was not statistically significant between the two groups (RR 1.44, 95% CI 0.72–2.91, p = 0.303). The 24-month reoperative rate was 53.3% in the PT group versus 13.3% in the ST group (RR 2.00, 95% CI 1.15–3.49, p = 0.015).

Conclusion The newly designed supratarsal gold weight showed superior postoperative outcomes than the standard traditional model.

Keywords

lagophthalmos - facial palsy - lid load - gold weight implantation - supratarsal implantation

Authors' Contributions

N.L.: study design, data collection, data analysis, data interpretation, writing—original draft, manuscript preparation


P.W.: implant design, data collection, review and editing in material part of manuscript


P.S.: study design, data interpretation, writing—review and editing manuscript, supervision


All authors read and approved the final manuscript.


All the authors were involved in the design of the study; the collection, analysis, and interpretation of data; and the writing and reviewing of the manuscript.


Ethical Approval

This study was approved by the Institutional Review Board and Ethics Committee, Faculty of Medicine, Chulalongkorn University. The study adhered to the tenets of the Declaration of Helsinki.


Patient Consent

Written informed consent was obtained from the author.


Note

This is an original manuscript. No plagiarism, fabrication, or falsification was involved in the writing of this paper.




Publication History

Received: 21 June 2023

Accepted: 24 October 2023

Article published online:
29 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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