Modern opportunities for correction of paralytic lagophthalmos

Facial paralysis can develop as a result of various causes due to anatomical features of the facial nerve. Ophthalmological risks are often not taken into account in rehabilitation and treatment aimed at restoring the functions of facial muscles and achieving favorable cosmetic results. However, lagophthalmos following denervation of the orbicularis oculi muscle can lead to irreversible decrease of visual acuity and even blindness. Therefore, maintaining the visual acuity is essential in patients with paralytic lagophthalmos. Static surgical techniques reducing or eliminating paralytic lagophthalmos have the greatest effect, predictable and stable results. The authors analyze 2.657 lagophthalmos corrections in patients with facial paralysis: correction of lower eyelid position (correction of lower eyelid ectropion and retraction using periosteal and mucoperiosteal flaps, suspension threads), correction of upper eyelid retraction and tarsoraphy. Correction of paralytic lagophthalmos through weighting the upper eyelid with palpebral implant is highlighted. The advantages and disadvantages of each technique, as well as appropriate indications are considered.