Purpose:
To develop an externally fixed magnetic system for tarsorrhaphy (MST) utilizing magnetized spectacles. While magnets have been suggested for use on the upper and lower eyelids,1 this novel model uses magnets placed on the lower rim of eyeglasses for improved control and cosmesis.
Methods:
Magnets were imbedded in medical grade polydimethylsiloxane (PDMS). Molds were designed through SolidWorks (http://www.solidworks.com), and created via Rapid Prototyping. The lenses were removed from spectacle frames (Surplus Glasses) and two large disk magnets made of Neodymium (diameter 1/8 inch, height 1/32 inch) on a wire brad (18 gauge by ¾ inch, 2g, Lowes) created a horseshoe magnet configuration. This was then scored with sandpaper and secured to the spectacle rim with a multipurpose polyurethane adhesive (Gorilla Glue). The following eyelid measurements were taken bilaterally in the 13 subjects prior to any
Results:
Magnetic placement resulted in complete closure of the eyelids in 10 of 13 subjects. Average palpebral fissure height without magnet placement was 9.6mm (9.6mm in subjects with closure, 9.5mm in those with minimal closure). The average margin reflex distance to the upper lid was 3.3mm (3.4mm in subjects with closure, 3mm in those with minimal closure). Placement of the magnet on the upper eyelid alone did not cause closure in any subject. After placement of the magnet and glasses, closure was complete in 10 subjects (see Figure 1). In the 3 subjects with minimal closure, average palpebral fissure height was 4.8mm.
Conclusions:
While magnets have been studied for the eyelid closure, no work has been conducted on a model where magnets are affixed to spectacles for improved cosmesis and patient control over the system. In this study, we report complete eyelid closure in 10 of 13 subjects and improved closure in 3 subjects with an MST utilizing magnetized specacles. Future studies are required to test this device in patients with paralytic lagophthalmos.
Keywords: cornea: tears/tear film/dry eye • quality of life • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials