The Effect of Palpebral Spring in Lagophthalmos caused by Nerve Palsy

ABSTRACT

Facial palsy produces asymmetry of the face and lagophthalmos, incomplete eyelid closure. Exposure keratitis and eyeball pain can be induced by prolonged lagophthalmos, and the vision can be treatened at last. Therefore, the correc tion of lagophthalmos is important to preserve the proper visual function. Tarsorrhaphy has been the classic method of providing corneal protection in lagophthalmos caused by facial nerve palsy, but it produces a cosmetic problem and limits vision, so it should be reserved only to comatous patients. Since Morel-Fatio and Lalardrie implanted a palpebral spring in 1964 first time, several modifications have been reported to maximize the effect of spring in lagophthalmos. The authors experienced the dynamic eyelid animation with papebral spring, custom-made by authors with orthodontic wire in four patients who sufferd from exposed keratitis and eyeball pain due to lagophthalmos, which were intractable to medical therapy. Eyeball pain and keratitis were completely subsided in all patients with good lid closure. One patient was removed the palpebral spring due to recovery of facial nerve function at postoperative 6 months, other three patinets are well with implanted pa.lpebral spring.