title: Treatment of paralytic lagophthalmos with gold weight implants covered by levator aponeurosis.
abstract: OBJECTIVE
  To describe a technique to treat paralytic lagophthalmos and exposure keratitis with gold weight implants covered by levator aponeurosis.
  
  
  METHODS
  The authors studied a case series of 29 patients who underwent surgical treatment for paralytic lagophthalmos using the technique of gold weight implantation covered by the aponeurosis of the levator palpebrae superioris muscle 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. Patients had significant improvement of symptoms, especially exposure keratopathy, with lagophthalmos dimensions decreased from 4 to 5 mm preoperatively to 0.5 mm after surgery.
  
  
  CONCLUSIONS
  Excellent results were obtained by recessing the levator palpebrae superioris muscle aponeurosis with relaxing incisions and advancing it to overly the gold weight implant completely. Visibility of the implant in the pretarsal upper eyelid surface was minimized, extrusion was avoided, and good eyelid position was obtained.
authors.affiliation: Oculoplastic Surgery Department of the 1st Infirmary of the Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil. s.lessa@alternex.com.br
authors.forename: Sergio
authors.initials: S
authors.lastname: Lessa
authors.forename: Marcelo
authors.initials: M
authors.lastname: Nanci
authors.forename: Roberto
authors.initials: R
authors.lastname: Sebastiá
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000009:adverse effects / Q000379:methods*; D005141:Eyelid Diseases / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D005158:Facial Paralysis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006046:Gold; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D006046:Gold