Surgical Procedures for Lagophthalmos during 13 years

Ahn, Sung Yul; Park, Hyang Joon; Kim, Jong Pill

Abstract

To affect the complete closure of the eyelids in leprosy patients with lagophthalmos, we have used various surgical methods to avoid using the temporalis transfer method. Although widely accepted as the most effective treatment for the chronic lagophthalmos patient, the temporalis transfer method creates a simultaneous involuntary closure of the eyelids while biting or chewing. This side effect creates a social stigmata which former leprosy patients wish to avoid. As a result, we have attempted to identify the most effective treatment which will also eliminate this involuntary closure of the eyelids during biting or chewing. In the upper eyelid, we performed gold plate implantation and levator muscle severing. In the lower eyelid, lateral tarsal strip, permanent medial tarsorrhaphy, horizontal shortening, cartilage grafting and alloderm graft have all been used in the treatment of ectropion. Based on our treatment of multiple patients, we now believe medial tarsorrhaphy supplemented with the various other methods mentioned above are insufficient to achieve the desired result of complete closure of the eyelids. As a result, we are now looking to a modified temporalis transfer procedure to ensure complete closure of the eyelids without the eye closing side effect.