Innovations in Treatment of Lagophthalmos and Exposure Keratopathy

Wolkow, Natalie; Chodosh, James; Freitag, Suzanne K.

doi:10.1097/iio.0000000000000185

Cited by 16 publications

(14 citation statements)

References 120 publications

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“…In our experience, the most satisfactory treatment for corneal exposure at night was taping the eyelid shut. Tape eyelid closures have been used by ophthalmologists to treat lagophthalmos from other causes 17,18 . For lagophthalmos caused by blepharoptosis, the mobility of the upper eyelid is poor, patients' blinking function has not yet recovered, and the traditional tape eyelid closure can withstand the force of the lower eyelid.…”

Section: Discussionmentioning

confidence: 99%

Tape Tarsorrhaphy in the Management of Lagophthalmos Caused by Severe Congenital Blepharoptosis Procedures

Sun,

Hao,

Cao

et al. 2024

Ann Plast Surg

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Background Lagophthalmos, a common complication after blepharoptosis correction, has plagued oculoplastic surgeons. The goal of this study was to investigate the effect of tape eyelid closure on reducing the occurrence of lagophthalmos after blepharoptosis correction. Methods From April 2020 to June 2021, a total of 112 patients with severe congenital ptosis received corrective surgery at the Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University. Of these, 48 underwent frontalis muscle advancement technique and 64 underwent conjoint fascial sheath suspension. Preoperative data collected included demographics, levator function, Bell's phenomenon, and marginal reflex distance 1 (MRD1). Postoperative data included surgery type, MRD1, eyelid closure function, aesthetic outcomes (including eyelid contour, eyelid symmetry, and eyelid crease), keratitis, and other complications. Results Frontalis muscle advancement technique group: the median of safe eye closure time was 7.3 months (positive Bell's phenomenon; interquartile range [IQR], 3.8–10.8 months) and 13.9 months (poor Bell's phenomenon; IQR, 11.6–16.1 months). There was a significant improvement between the preoperative and postoperative MRD1 (−1.52 ± 0.82 vs 3.85 ± 0.58 mm, P < 0.05). Conjoint fascial sheath suspension group: the median of safe eye closure time was 5.7 months (positive Bell's phenomenon; IQR, 2.9–8.5 months) and 12.4 months (poor Bell's phenomenon; IQR, 8.1–16.7 months). There was a significant improvement between the preoperative and postoperative MRD1 (−1.02 ± 0.91 vs 4.15 ± 1.03 mm, P < 0.05). All patients/guardians were satisfied with the aesthetic outcomes. Conclusions Tape tarsorrhaphy is a safe, easy-to-learn method for treating lagophthalmos with a good aesthetic outcome.

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Section: Discussionmentioning

confidence: 99%

Tape Tarsorrhaphy in the Management of Lagophthalmos Caused by Severe Congenital Blepharoptosis Procedures

Sun,

Hao,

Cao

et al. 2024

Ann Plast Surg

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“…Essa técnica, por fazer uso da gravidade, proporciona excelente fechamento palpebral vertical. (27) (figura3) Embora tecnicamente seja rápida e eficaz, atualmente não está mais disponibilizada no SUS no presente momento; assim alternativas como cantoplastia de Tessier e tarsorrafias são as opções mais viáveis no momento. Especial atenção deve ser dada à cantoplastia de Tessier, que permite a diminuição da fenda palpebral vertical e horizontal.…”

Section: Discussionunclassified

Lagophthalmos in leprosy: clinical experience in an Amazon reference center

Bentes¹,

Matayoshi²,

Talhari³

2021

Revista Brasileira De Oftalmologia

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Objetivo: O presente trabalho teve por objetivo caracterizar o perfil epidemiológico e clínico de pacientes com lagoftalmo associado à hanseníase, atendidos no ambulatório de oftalmologia da Fundação Alfredo da Matta, Manaus, Amazonas. Métodos: Trata-se de estudo retrospectivo realizado por meio da análise dos prontuários clínicos dos pacientes incluídos no estudo. Sexo, idade, forma clínica, grau de incapacidade no diagnóstico e desfecho foram obtidos dos prontuários. Início, tipo de comprometimento (unilateral ou bilateral), grau de intensidade do lagoftalmo e alterações oculares associadas também foram compilados. Resultados: Foram incluídos 65 pacientes; 66,1% eram do sexo masculino e 53,8% tinham idade superior a 60 anos. Em relação à classificação operacional da hanseníase, a maioria dos pacientes (81,5%) era multibacilar: 33,8% na forma de hanseníase borderline e 47% virchowiana. 36,9% casos apresentavam sequelas oculares associadas ao lagoftalmo: opacidade corneana, epífora, ceratopatia em faixa, e neovascularização corneana.41,6% evoluíram para a cegueira. O lagoftalmo foi conduzido de forma clínica em 23 pacientes e a abordagem cirúrgica foi indicada em 42. Em relação ao tratamento cirúrgico consistiu principalmente no implante de peso de ouro e na cantoplastia de Tessier. Discussão: O lagoftalmo nessa casuística acometeu mais homens idosos, esteve relacionado à forma multibacilar, com hanseníase do tipo virchowiano como relatado na literatura. O diagnóstico de lagoftalmo foi tardio na maioria dos casos, explicando o grande número de sequelas incluindo a cegueira. Conclusão: O presente estudo reforça a necessidade de acompanhamento oftalmológico precoce para que as potenciais e graves sequelas associadas a essa condição sejam evitadas.

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“…The patient was counseled on these conditions and their association with obstructive sleep apnea (OSA). Temporizing treatment options were discussed, including continued aggressive lubrication, taping of the eyelids, and moist chamber goggles 7 . However, it was reiterated that surgical intervention would be necessary for definitive treatment.…”

Section: Case Presentationmentioning

confidence: 99%