title: Corneal astigmatism with upper eyelid gold weight implantation using the combined high pretarsal and levator fixation technique.
abstract: 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.
authors: Corneo Plastic Unit, The Queen Victoria Hospital, East Grinstead, United Kingdom.
authors: George M
authors: GM
authors: Saleh
authors: Ioannis
authors: I
authors: Mavrikakis
authors: Jean-Louis
authors: JL
authors: de Sousa
authors: Wen
authors: W
authors: Xing
authors: Raman
authors: R
authors: Malhotra
mesh_terms: 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
chemical_list: D001672:Biocompatible Materials; D006046:Gold