[Surgical and conservative treatment of lagophthalmus (facial paralysis). II].

Thirty patients with irreversible facial palsy were treated with gold implants from 0.5 to 1.8 g. For the immediate treatment of postoperative facial palsies and reversible kinds of lagophthalmos, lead weights of 1.2 to 1.8 g ("lid dynamic eye dressing") are preferred to hourglass dressings. Insufficient orbicularis muscle function is compensated by the weight. The observation time for gold implants is more than 2 years; the fixation time of the adhesive lead weights is 1 to 10 days. Tolerance is excellent to both treatments. The principle is gravity dependent and is limited to the vertical and oblique head position. For sleeping at night, ointment application and pressure on the upper lid by a pillow are advisable; an additional hourglass dressing is possible. No serious keratopathies were seen in any cases. All patients found the return of lid motility from the restored levator muscle function to be a functional and cosmetic advantage. After weighing the advantages and disadvantages, especially the operative/technical expense in relation to the effective results, it would appear that simple lid-loading is so far the best method of treating lagophthalmos.