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Benjamin M. Levine, Anne Barmettler, Mark I. Rosenblatt, Nadee Nissanka, Rohina Rao, David Lipson, Gary J. Lelli, Jr.; Magnetic Field For Eyelid Closure In Patients With Corneal Exposure. Invest. Ophthalmol. Vis. Sci. 2011;52(14):741.
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To present a novel technique for the treatment of paralytic lagophthalmos and exposure keratopathy with an externally affixed magnetic system for tarsorrhaphy (MST).
In conjunction with Cornell Bioengineering, magnets were set in silicone molds made of polydimethylsiloxane (PDMS) potting solution. The molds were created to be as thin as possible, curvilinear to approximate the normal eyelid architecture, and utilized 3M Medipore tape for applying the MST to the eyelid. In vivo testing of the MST was performed with 5 normal human volunteers. The following eyelid measurements were taken bilaterally in the subjects prior to any
Prior to MST placement, palpebral fissure height (average + SD) was 9.8mm + 0.75. The margin reflex distance to the upper lid was 3.3mm + 0.6 and the margin reflex to the lower lid was 6.5mm + 0.32. After placement of the MST, palpebral fissure height was 2.4mm + 1.02. The margin reflex distance to the upper lid was 0.6mm + 1.04 and the margin reflex distance to the lower lid was 1.8mm + 0.4.
There are many possible solutions to the complications of paralytic lagophthalmos. To date, none are ideal. Temporary tarsorrhaphies can result in eyelid margin notching, trichiasis, ectropion, and epithelial cyst formation after tarsorraphy takedown6-8. Permanent tarsorrhaphies create visual field defects and are cosmetically unappealing. Implantation solutions can cause allergic reactions, migrate, or extrude. Tissue flaps and grafts are surgically complicated and other reconstructive techniques only provide a limited amount of corneal protection, impair spontaneous blinking, are typically static in nature, and not easily reversible. While the use of eyelid magnets was explored in Europe in the 1970s and 1980’s with reported success in the past, this was done in a permanent manner through implantation in the upper and lower lids9-10. This idea is revisited in a manner that can be temporary or reversible and with the use of more current, smaller and stronger bioengineered magnetic options.
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