Noninfectious inflammatory reaction to a gold weight eyelid implant: A case report and literature review.

Upper eyelid loading with a gold weight is a generally well-tolerated procedure that helps reduce corneal exposure in patients with lagophthalmos. Complications of this procedure are infrequent. The authors present a rare case of a noninfectious inflammatory response to an eyelid gold weight implant in a 48-year-old woman and summarize all previously published cases. This particular patient presented with incomplete left eyelid closure secondary to a trauma. After having a gold weight inserted into her eyelid to improve closure, she returned with edema and erythema of the eyelid. The inflammation did not respond to oral antibiotics; however, oral steroid therapy resulted in prompt resolution of her symptoms. Her symptoms recurred after discontinuing steroid use and she subsequently required removal of her gold weight implant for permanent resolution of her eyelid inflammation. Although rare, this reaction poses a serious management issue, because it does not respond to antibiotics or short-term steroid use and, in most cases, requires removal of the gold implant.