Müller-Jensen G, Müller-Jensen K
Städtisches Klinikum Karlsruhe, HNO-Klinik.
Klin Monbl Augenheilkd. 1995 Aug;207(2):87-90. doi: 10.1055/s-2008-1035353.
In facial palsies with lagophthalmic keratopathy an hour-glass dressing is indicated, which has the disadvantage of a moisture chamber with visual impairment by steaming up. After weeks of placement dermal irritations are possible. An alternative is the gravity dependent lidloading, using gold implantation in cases of irreversible lagophthalmos.
Lead weights of 0.8 to 2.0 g are glued to the upper lid with an adhesive layer, that is well tolerated by the skin (Combihesive*), or by a simple foil that is glued on both sides (Tesafix). This results in a lidclosure without impairment of lid opening. After tests on 10 normal persons the described method was placed on 22 patients with lagophthalmos and compared with hour-glass dressing. The new method was applied to 36 additional patients.
The dynamic lead weight is effective and well-tolerated. It was more accepted cosmetically especially during the day because of better cosmetic appearance and better visual function than was the hour-glass dressing. These latter dressings are still important for use in serious cases during the night.
lidloading with lead weights that are glued by an adhesive layer to the upper lid can be recommended as a new method in cases of reversible lagophthalmos or as a preparatory step before gold implantation.
在伴有兔眼性角膜病变的面瘫患者中,需要使用沙漏形敷料,但这种敷料存在潮湿腔室的缺点,会因蒸汽导致视力受损。放置数周后可能会出现皮肤刺激。另一种方法是重力依赖性眼睑负重,对于不可逆性兔眼症可采用植入金片的方式。
将0.8至2.0克的铅锤用皮肤耐受性良好的粘合剂层(Combihesive*)或两面都粘贴的简单箔片(Tesafix)粘在上眼睑上。这样可实现眼睑闭合而不影响睁眼。在对10名正常人进行测试后,将所述方法应用于22例兔眼症患者,并与沙漏形敷料进行比较。该新方法又应用于另外36例患者。
动态铅锤有效且耐受性良好。从美容角度看,它更易被接受,尤其是在白天,因为其美容效果和视觉功能优于沙漏形敷料。而后者在严重病例的夜间使用中仍然很重要。
对于可逆性兔眼症,或作为植入金片前的准备步骤,可推荐使用通过粘合剂层将铅锤粘在上眼睑的眼睑负重方法。