Modified silicone sling assisted temporalis muscle transfer in the management of lagophthalmos

• Main Authors: Ramesh C Gupta, Raj NS Kushwaha, Ina Budhiraja, Priyanka Gupta, Parul Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Blindness; cataract; eye lens; risk factors; treatment of cataract; Low vision care; multiple disabilities and visual impairment; reading performance; Accommodation; presbyopia; supraciliary segment implants; Amblyopia; citicoline; patching; Corneal endothelium; human corneal endothelial precursor cells; in vitro expansion; sphere forming assay; thermo-reversible gelation polymer; transportation; Endophthalmitis; explantation; fungal; intraocular lens; postoperative; recurrent; Colour perception; learning disabilities; school children; stereo acuity; testability; visual acuity; Contracted socket; dermis fat graft; porous orbital implant; reconstruction; Glucose; in vitro anticataract; lens; Moringa oliefera; ′BARC I-125 Ocu-Prosta seeds′; choroidal melanoma; ciliary body melanoma; Episcleral plaque brachytherapy; retinal angioma; retinoblastoma; vasoproliferative tumor; Congenital glaucoma; gonioscopy; Retcam; Acoustic features; A-scan; B-scan; choroidal mass; ultrasound biomicroscopy; Cataract surgery; education; informed consent; multimedia; rural health; Lagophthalmos; silicone sling; temporalis muscle
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=2;spage=176;epage=179;aulast=Gupta
• ISSN: 0301-4738; 1998-3689

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 1 st postoperative day, and 0.7 (0.75) mm at 3 rd 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 1 st postoperative day, and 10.35 (1.08) mm at 3 rd 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.