Deficient eyelid closure is a major visual threat to patients with unresolved facial nerve
palsy.
Gold weight implants assisted eyelid closure in patients with
paresis of the orbicularis oculi, ameliorating patient complaints of
dry eye, excessive tearing, and corneal epithelial breakdown. We used dynamic measures to assess the efficacy of upper eyelid
gold weight implantation surgery for facial nerve
palsy. The search coil technique was used to record spontaneous blinks bilaterally in six patients, before and after unilateral
gold weight implantations into the upper eyelid in severe facial nerve
palsy. In uncomplicated facial nerve
palsy, the amplitude of blink down-phases for the paretic eyelid was 28.6 +/- 5.7% of the amplitude of the contralateral, normal eyelid. Following corrective surgery, closure of the paretic eyelid improved to 42.6 +/- 7.5% (P < 0.05). There was not a commensurate increase in the peak velocity of blink down-phases, suggesting that
gold weight effects are mediated by a passive improvement in blink dynamics.