Upper Eyelid Gold Weight Insertion/Lower Eyelid Tightening
Patients who develop a Bell’s palsy or facial paralysis for other reasons are often unable to close their eyelids. The exposure of their eyes predisposes them to corneal drying, excessive tearing, infections and corneal breakdown. To prevent corneal drying and corneal ulceration it is imperative to keep the eye moist at all times. This can be accomplished initially with the use of artificial tears and lubricating ointments. Some patients will also benefit from a protective plastic “eye-bubble” that is temporarily placed over their eye and eyelids which acts like a moisture chamber that retains moisture on the surface of their eye. After this initial phase of therapy, Dr. Kopelman recommends a surgical procedure that will allow the patient to fully close their eyelids. This procedure involves the insertion of a tiny piece of gold, which is biologically inert, beneath the upper eyelid skin and muscle. The gold implant acts as a passive weight that allows you to eyelid to close by the gravity. However, this gold weight will not affect your ability to open your eyelid. When you tense the muscle, your eyelid will open. The complete closure of your eyelids over your cornea will protect your eye and your vision and result in greater comfort.
Facial paralysis also encompasses lower eyelid weakness as well. When the lower eyelid muscle tone is diminished the lower eyelid is will hang down and will not abut the lower aspect of the eye. This results in greater exposure of the lower half of the cornea and because the eyelid cannot pump tears into the tear duct efficiently water accumulates inside the lower eyelid which will blur your vision and precipitate constant tearing. A solution to alleviate these symptoms is a surgical procedure to tighten the lower eyelid. Dr. Kopelman will perform a procedure that will decrease exposure of the lower aspect of the eye and diminish tearing. The surgery is performed under light intravenous sedation and usually takes approximately 30 minutes. Most patients are discharged from the recovery room in one hour. Post-operative discomfort is typically controlled with oral acetoaminophen (Tylenol) and topical lubricating eye drops. Eyelid sutures are typically removed in approximately one week.