Dacron mesh encasement of gold weight implants in paralytic lagophthalmos

Purpose: The purpose of this study is to evaluate the efficacy of Dacron mesh used as an encasement material for gold weight implantation, which is a new therapeutic technique, in patients with paralytic lagophthalmos. Materials and Methods: Fifteen eyelids of 14 patients with paralytic lagophthalmos, who underwent surgery with Dacron mesh-covered gold implants, were retrospectively reviewed. None of the patients had any eyelid surgery, and none had orbital or any other eyelid disease. All patients had various degrees of preoperative corneal pathology due to lagophthalmos. The patients were followed up for a mean of 17.5 ± 12.4 months (range: 6-36 months), and both postoperative success and complications were reported. Pre- and post-operative lagophthalmos degrees were compared between cases with successful results and cases with complications. Preoperative lagophthalmos degrees of <9 mm versus ≥9 mm were also compared between successful and complicated cases. The Wilcoxon signed test was used to measure mean differences between pre- and post-operative values. Differences were statistically significant when P < 0.05. Results: During final visits, while 13 of 15 operated eyelids had adequate lid closure with no complications, 3 of 15 patients developed inflammation and infection in the early postoperative period. During follow-up, two of complicated patients responded to treatment poorly, and implants were removed. Skin ulceration was observed in the third patient, and the implant was replaced with a new one with no Dacron coverage, achieving adequate lid closure and satisfaction. Conclusions: Dacron mesh may be a good option as a barrier for gold weight implants to prevent implant extrusions; however, the high rate of early postoperative inflammation raises concerns about its use