title: Platinum segments: a new platinum chain for adjustable upper eyelid loading.
abstract: OBJECTIVE
  Prospective study evaluating outcomes of individually sutured platinum segment chains in upper eyelid loading.
  
  
  METHODS
  Single-centre, single-surgeon, prospective study. Upper eyelid loading with 0.4 and 0.2 g platinum segment chains for lagophthalmos. Segments were sutured to create a desired weight and attached to superior tarsus and distal levator aponeurosis following levator recession.
  
  
  METHODS
  improvement in lagophthalmos and complications.
  
  
  METHODS
  cosmesis of eyelid margin contour and implant prominence. Minimum 3-month follow-up.
  
  
  RESULTS
  Eighteen eyelids of 17 patients received segment chains (mean weight 1.2 g, range 0.8-1.6 g) and 3 for exchange of pre-existing gold weights. Median follow-up was 10 (range 6-17) months. Mean blink lagophthalmos improved from 7 (3-10) mm to 3 (0-6) mm (p<0.0001), and gentle closure from 3.2 (0-8) mm to 1.1 (0-4.9) mm (p=0.0004). Twelve patients (71%) reported no prominence, and the remainder, mild prominence only. The chain was graded as having no prominence in 78% (14/18) eyelids. Two required segment adjustments with removal of a single 0.2 g segment at 11 months and transfer of 0.4 g segment to the contralateral eyelid at 16 months, respectively. One complication (posterior, trans-conjunctival exposure above the superior border of the tarsal plate) was seen 12 months post surgery, requiring repositioning.
  
  
  CONCLUSIONS
  Platinum segment chains provide benefits of platinum chains with additional advantages of postoperative adjustibility. They can be used as an addition to pre-existing in situ weights or chains.
  
  
  BACKGROUND
  REC reference: 13/SW/0146. IRAS project ID: 119022.
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
authors.forename: Raman
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
authors.forename: Kimia
authors.initials: K
authors.lastname: Ziahosseini
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Poitelea
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
authors.forename: Andre
authors.initials: A
authors.lastname: Litwin
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sagili
mesh_terms: D000328:Adult; D000368:Aged; D005141:Eyelid Diseases / Q000503:physiopathology / Q000601:surgery*; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D017060:Patient Satisfaction; D010984:Platinum; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D014792:Visual Acuity / Q000502:physiology
chemical_list: D010984:Platinum
keywords: Eye Lids; Rehabilitation; Treatment Surgery