Malik Adeela, Joshi Naresh
a Moorfields Eye Hospital, NHS Foundation Trust , London , United Kingdom.
b Chelsea and Westminster Hospital, NHS Foundation Trust , London , United Kingdom.
Orbit. 2017 Oct;36(5):347-349. doi: 10.1080/01676830.2017.1337176. Epub 2017 Jul 5.
A retrospective audit was conducted of four patients with upper eyelid gold weights (inserted >5 years ago) as treatment for facial nerve palsy-related lagophthalmos. Each patient was presently examined for lagophthalmos ("opened" or "closed") at three different patient inclinations (lying flat at 0º, lying back at 45º, and sitting upright at 90º). In all four cases at 0º inclination, the upper eyelid remained "open" with significant lagophthalmos, and therefore the ocular surface was vulnerable. At other inclinations, 45º and 90º, the eyes were substantially "closed" and the ocular surface was protected. We discuss the mechanism by which this occurs. We suggest that patients fitted with upper eyelid gold weight implant who do not show adequate closure during postoperative clinical examination or signs of corneal show should try sleeping in a slightly upright position to aid ocular surface protection.
对4例植入上睑金重物（植入时间>5年）以治疗面神经麻痹相关兔眼症的患者进行了回顾性审计。目前对每位患者在三种不同的身体倾斜度（平卧位0º、后仰位45º和直立位90º）下检查兔眼症情况（“睁眼”或“闭眼”）。在所有4例患者中，0º倾斜度时上睑保持“睁眼”状态，存在明显兔眼症，因此眼表易受伤害。在其他倾斜度，即45º和90º时，眼睛基本“闭合”，眼表得到保护。我们讨论了这种情况发生的机制。我们建议，植入上睑金重物的患者若在术后临床检查中未表现出足够的眼睑闭合或角膜暴露迹象，应尝试稍微直立位睡眠以帮助保护眼表。
