Abstract
Purpose :
There are a variety of surgical options to address paralytic ectropion, including canthoplasty, tarsorrhaphy, suspension techniques with fascia lata, and lower eyelid spacer implants. We performed a retrospective, observational clinical study to assess how a novel lower eyelid thin profile, biointegratable, porous polyethylene implant may be used to manage the symptoms and signs of paralytic ectropion.
Methods :
Fifteen consecutive patients with facial nerve paralysis and resultant paralytic ectropion who underwent Su-Por AIRO lower eyelid spacer placement and lower eyelid canthoplasty by a single surgeon (MAB) between September 2017 and July 2018 were included in this retrospective, observational clinical study. Patient demographics, pre- and post-operative lagophthalmos and margin-reflex distance 2 (MRD 2) measurements, patient satisfaction, and complications were studied. Paired t-test was used for statistical analysis.
Results :
Mean patient age was 69 years (range: 50 – 97). Etiology of facial nerve palsy was iatrogenic (7), nonresolving Bell’s palsy (3), ischemic (3), traumatic (1), and other (1). There were no intraoperative complications. All patients reported subjective improvement in comfort and had decreased eye drop dependence. Lagophthalmos improved from a mean of 5.7 mm (±3.2, range from 1 to 14 mm) to 1.3 mm (±1.4, range from 0 to 5 mm), p<0.01. MRD 2 improved from a mean of 6.3 mm (±2.5, range from 2 to 12 mm) to 4.0 mm (±1.1, range from 2.5 to 7 mm), p<0.01. No patients needed additional lower eyelid surgery. There were no implant exposures, extrusions, or infections at a mean follow up of 6.1 months (±5.8, range: 0.7 -14).
Conclusions :
The use of AIRO lower eyelid implant to manage paralytic ectropion showed success with improved patient comfort, decreased eye drop dependence, improved MRD 2 and lagophthalmos. Future prospective studies and longer follow up are necessary to evaluate the long term success of the Su-Por AIRO lower eyelid spacer implant.
This is a 2020 ARVO Annual Meeting abstract.