A Rare Case Handled Well

Spigelian Hernia Surgery

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Dr. A. S. Bath

Dr. A. S. Bath
Sr. Consultant & Head
BLK Centre for Plastic &
Cosmetic Surgery
BLK Super Speciality
Hospital, New Delhi




An Eye-opening Surgery
To Close An Eye

Gold Implant of the eye

THE CASE
A 25-year-old was involved in a road accident leading to complete palsies of the 6th and 7th cranial nerves on the left side of his face. He was unable to close his eye in spite of recovery and he had excessive watering from the left eye. Ophthalmologists and Neurosurgeons advised surgery for eyelid closure.

THE PROCEDURE
The patient was brought to BLK Centre for Plastic and Cosmetic Surgery where a detailed examination revealed incomplete palsy of 7th facial nerve with complete palsy of orbicularis oculi muscle. The patient was taken up for implantation of gold weight in left upper lid. Gold weight plate 18mm x 3mm and 1 gram in weight was fixed to upper half of upper lid tarsal plate through tarsal skin fold incision.

THE RESULT
After two weeks, edema of eyelid subsided and the patient was able to have complete closure of left eye even during sleep. His excessive watering from left eye subsided and the redness of the eye gradually disappeared.

DISCUSSION
Several techniques are available for management of lagophthalmos to overcome the unopposed action of the levator palpebrae superioris muscle in cases of facial nerve palsy. Because of inertness of 24-carat gold, lid loading with Gold Implant gives excellent aesthetic and functional results. It does so without any complications of donor site morbidity, unaesthetic bulge over orbital rim / zygomatic arch and unaesthetic appearance of lid aperture, associated with other procedures using autogenous tissues