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IP International Journal of Ocular Oncology and Oculoplasty


LPS recession in permanent 7th nerve palsy to protect cornea


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Author Details: Mohammed Ather, Kesava Rao, MR Flarence, T. Sai Shreya, Raheel Raza

Volume : 2

Issue : 4

Online ISSN : 2581-5016

Print ISSN : 2581-5024

Article First Page : 236

Article End Page : 239


Abstract

 Aim: To study the effect of LPS recession in permanent 7th nerve palsy to protect cornea.

Materials & Methods: This is a Prospective interventional study conducted at the Department of Oculoplasty and Orbital diseases of Sarojini Devi Eye Hospital which is attached to Gandhi Medical College between 2012-2014. 36 eyes of 33 patients who had lagophthalmos due to permanent type of 7th nerve palsy were included in the study. Patients who had temporary type of facial palsy like Bell’s palsy and those patient with permanent palsy having paralytic ectropion and patients who already underwent any procedure to correct lagophthalmos were excluded from the study. All patients were clinically examined to establish the cause of lagophthalmos. MRD1, amount of Lagophthalmos was measured and exposure keratopathy was documented by staining cornea with Flourescien sodium. Surgical profile was done in all patients. LPS recession was done under local anaesthesia. Patients were followed up on 1st day, 1st week, 2nd week and 4th week after LPS recession. On every visit MRD1, amount of lagophthalmos was measured and corneal staining was done to see the healing effect.

Results: There was mean reduction of 3.89 mm in MRD1 and 5.47 mm in the amount of lagophthalmos in all cases after 1st week. At the end of 2nd week all cases started showing healing of cornea. By the end of 4th week 28 cases showed total healing of exposure keratopathy. Only 8 cases showed non-healing of cornea after 4th week. These cases had neurotrophic keratopathy because of Hansens.

Discussion: LPS recession achieve results similar to Gold weight implant. It is cheap and can be used as an alternative to gold weight implant.


Keywords: 7th Nerve palsy, MRD1 (Mean reflex distance), LPS (Levator palpebral superioris), Exposure keratopathy, Lagophthalmos