Corneal astigmatism with upper eyelid gold weight implantation using the combined high pretarsal and levator fixation technique.
OBJECTIVE
To evaluate corneal astigmatism with the combined high pretarsal and levator fixation gold weight implantation technique.


METHODS
Twenty-one eyelids of 21 patients with facial nerve palsy were prospectively enrolled. All patients underwent upper eyelid gold weight implantation using the combined high pretarsal and levator fixation technique. Keratometry and automated refraction were performed preoperatively and postoperatively. Five patients were excluded from final analysis because of incomplete keratometry data. The data were analyzed looking for statistically significant changes in lagophthalmos, automated refraction, and keratometry.


RESULTS
A statistically significant improvement in lagophthalmos with spontaneous blinking (p = 0.0014), and gentle (p = 0.0016) and forced (p = 0.0027) closure was noted postoperatively. No significant differences were found when comparing preoperative and postoperative automated refraction readings (p = 0.89, p = 0.88), automated refraction axis (p = 0.71), keratometry readings (p = 0.40, p = 0.77), or keratometry axis (p = 0.63).


CONCLUSIONS
Implantation of a gold weight in the upper eyelid with the combined high pretarsal and levator fixation technique does not appear to cause a significant change in corneal astigmatism. This is contrary to data for pretarsal gold weight implantation, which does induce significant with-the-rule corneal astigmatism.
Saleh
George M
GM
Corneo Plastic Unit, The Queen Victoria Hospital, East Grinstead, United Kingdom.
Mavrikakis
Ioannis
I
de Sousa
Jean-Louis
JL
Xing
Wen
W
Malhotra
Raman
R
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000503:physiopathology*; D001672:Biocompatible Materials; D003315:Cornea / Q000503:physiopathology*; D005141:Eyelid Diseases / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000601:surgery*; D005260:Female; D006046:Gold; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D019919:Prosthesis Implantation
D001672:Biocompatible Materials; D006046:Gold