Modified silicone sling assisted temporalis muscle transfer in the management of lagophthalmos.
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Date
2014-02
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Abstract
Aim: To evaluate the efficacy of modified temporalis muscle transfer (TMT) by silicone sling for the
management of paralytic lagophthalmos. Settings and Design: Prospective interventional study.
Materials and Methods: Ten patients of lagophthalmos due to facial palsy underwent modified TMT using
silicone sling. The patients were followed‑up for a period of 3 months. Palpebral aperture in primary gaze
and during eye closure were assessed both pre‑ and postoperatively along with problems associated with
lagophthalmos like exposure keratopathy and lacrimation. Statistical Analysis: Paired t‑test was applied
to measure the statistical outcome. Results: Eight patients achieved full correction of lagophthalmos with
no lid gap on closing the eye. The mean (standard deviation (SD)) lid gap on eye closure was 7.7 (0.86) mm
preoperatively, 0.5 (0.47) mm at 1st postoperative day, and 0.7 (0.75) mm at 3rd month. There was a reduction
in mean lid gap on eye closure of 7 mm at 3 months (P < 0.0001) which is highly significant. The mean (SD)
vertical interpalpebral distance during primary gaze was 12.05 (1.12) mm preoperatively, 10 (0.94) mm at 1st
postoperative day, and 10.35 (1.08) mm at 3rd month. There was a reduction in mean vertical inter palpebral
distance of 1.7 mm at 3 months (P = 0.001) which is significant. Exposure keratitis decreased in five out of six
patients at 3 months. Conclusion: Modified TMT by silicone sling is a useful procedure with lesser morbidity
and good outcomes for the treatment of paralytic lagophthalmos due to long standing facial palsy.
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Keywords
Lagophthalmos, silicone sling, temporalis muscle
Citation
Gupta Ramesh C, Kushwaha Raj N S, Budhiraja Ina, Gupta Priyanka, Singh Parul. Modified silicone sling assisted temporalis muscle transfer in the management of lagophthalmos. Indian Journal of Ophthalmology. 2014 Feb ; 62 (2): 176-179.