POURPOSE: To demonstrate an improvement in paralytic lagophthalmos surgical treatment complications and aesthetic results by covering the gold weight implants with the levator palpebrae muscle aponeurosis. METHODS:We studied a case series of twenty nine patients presenting idiopatic facial palsy with more than 4 years of clinical evolution, submitted to paralytic lagophthalmos surgical treatment using a modification of the technique of gold weight implantation covered by the aponeurosis of the levator palpebrae superioris muscle (Gladstone, 1996) between June 1997 and December 2006. None had undergone previous surgical treatment. RESULTS:All patients sustained their implants. There were no cases of extrusion, dislocation or infection, with clinical symptoms improvement and lagophthalmos reduction. CONCLUSION:By widely dissecting the levator palpebrae superioris muscle aponeurosis, exceeding it and recovering the implant completely, we obtained excellent results. The pretarsal upper eyelid surface became regular, extrusion was avoided and, comparatively to Gladstone's technique that performs an aponeurotic plication over the gold weight implant, we managed to obtain a better adjustment of the superior eyelid final positioning after implant coverage.
Facial palsy; Eyelid diseases; Eyelid diseases; Gold; Ophthalmologic surgical procedures
