Gold weight implantation and lateral tarsorrhaphy for upper eyelid paralysis.

Background: Upper eyelid paralysis leads to lagophthalmos with the risk of exposure keratitis, corneal ulceration and blindness.

Methods: Consecutive patients undergoing gold weight implantation and/or lateral tarsorrhaphy were identified from our prospective database and reviewed.

Results: Sixty-three patients were identified, 36 of whom underwent immediate reanimation procedure either during cancer excision (n = 35) or repair of facial laceration (n = 1). Twenty-seven patients had a delayed procedure either following tumour excision (n = 21) or unresolved Bell's palsy (n = 3), or facial palsy due to complex craniofacial fracture (n = 3). Nine patients required revision to achieve optimal weight. Fifty-two patients had full eye closure. The remaining 11 patients had almost complete eye closure.

Conclusions: Facial paralysis is devastating for the patient and immediate facial reanimation should be performed. We have demonstrated that gold weight implantation and lateral tarsorrhaphy are simple and effective in achieving eye closure.