Patient satisfaction after lid loading in facial palsy

Paralytic lagophthalmos is treated by pretarsal implantation of eyelid weights consisting either of rigid gold weights or flexible platinum chains. Functional results being good, subjective patient satisfaction has been examined only by a small number of studies. The aim of our study, conducted by means of a questionnaire, was to assess subjective patient satisfaction after implantation of different eyelid implants. Questionnaires were sent to 42 patients treated by pretarsal implantation of a gold weight (group 1) and 51 patients with a pretarsally fixed platinum chain (group 2). In total, 46 response sheets were evaluated (16 × gold weight, 30 × platinum chain) and the results were compared. In group 1, 75% of patients were very satisfied to satisfied with the overall result. In group 2, 100% of patients were very satisfied to satisfied with the overall result. In group 1, an infection occurred in 6.5% of patients, an extrusion in 6.5%, and a change of vision in 31%. In group 2, inflammation occurred in 13%, extrusion in 0%, and a change of vision occurred in 13% of patients. On a visual analogous scale from 1 to 10 (1, very good; 10, very poor), group 1 assessed the cosmetic result with an average grade of 3.8 and the functional result with an average grade of 3.1. Group 2 assessed the cosmetic result with the grade 2.9 and the functional result with grade 3.0. The implantation of an eyelid weight for treatment of paralytic lagophthalmos was assessed as positive by a majority of patients. When compared with conventional gold implants, patients who have been treated with a flexible platinum chain are overall more satisfied and have a more favorable subjective view of the cosmetic results.