I have a
patient who is a candidate for Eyelid Weight
Implantation; what’s my next step? How do I go about
ordering this product?
First you need to determine the
correct Eyelid Implant Weight for your patient using
MedDev’s Tantalum Weight Sizing Set. MedDev’s
Sizing Set contains a series of seven weights ranging
from 0.6 gram to 1.8 gram, by 0.2 gram increments. The
weights adhere to the upper eyelid to determine the
appropriate weight for optimum eyelid closure. Once the
appropriate weight is determined, MedDev offers Gold and
Platinum implants in either ThinProfile™ (0.6
mm thickness) or Contour™ (1.0 mm thickness)
implant designs. Please contact our customer service
support staff for additional information.
Most MedDev products are in stock and available for
How do I determine the correct weight implant for my
The easiest way to determine the
correct weight is to order MedDev’s Tantalum Weight
Sizing Set. The Standard Sizing Set consists of
seven suitably contoured weights corresponding to the
most common implant sizes. These sizing weights can be
temporarily applied to the patient’s eyelid to evaluate
a patient’s requirements. The sizing set also includes
a supply of double-stick, hypoallergenic adhesive strips
to adhere the weights to the upper lid. Alternatively,
any medical grade adhesive can be used for adhesion.
Two adhesives commonly used are Mastisol and Benzoin.
Weight sizing is done preoperatively.
The following are MedDev’s Sizing Instructions:
1. Place the EyeClose®
Adhesive Strip on the concave side of the 1.0 gram
sizing weight. (Note: Instructions for use of the tape
are included in the adhesive tape box.)
2. With the patient sitting upright,
affix the weight to the upper eyelid approximately 3.0
mm above the lash line, centered at the junction of the
medial and central thirds of the eyelid (See Figure 1).
At this point the action of the levator function is
3. Note the position of the eyelid as
the patient looks up and down.
4. Increase or decrease the sizing
weight until the best result is achieved. Because the
levator seems to strengthen over time after the weight
is added, the optimal weight is usually that which holds
the lid about 1.0 mm lower than the normal lid as the
patient looks straight ahead.
Once the appropriate weight is
determined, the corresponding implant may be chosen in
either Gold or Platinum and in our Contour or
How soon after the onset of facial paralysis and
lagophthalmos should the patient receive an Eyelid
If a patient is diagnosed with
lagophthalmos and expectations are for prolonged or
incomplete recovery, the patient is a suitable candidate
for the Eyelid Implant procedure. If the facial nerve
is intact and recovery is likely, as with Bell’s palsy
patients, supportive care utilizing an External Eyelid
Weight in conjunction with ocular lubricants can be
indicated for the first six months, during which time
facial nerve function can be monitored. If paralysis
resolves after implantation of an Eyelid Weight, the
procedure is easily reversed.
Will the eyelid close with the patient sleeping in the
The orbital septum that extends from
the upper portion of the tarsal plate to the upper
orbital rim is a thin sheet of fibrous tissue that
attaches to the orbit just below the eyebrow. When the
eye is closed lying down, this tissue is relatively
flat, preventing the Eyelid Weight from going back into
the orbit. If the weight is placed incorrectly behind
the orbital septum, it can inadvertently pull the lid
open, as the weight falls back towards the orbit on the
surface of the levator muscle that is behind the orbital
Have the implants been reported to extrude from the
Pickford reported an extrusion rate of
12% among 41 patients in an article published in the
British Journal of Plastic Surgery.1 These
implants, however, were not designed with suture
holes through which adhesions could form for secure,
In response to the Pickford article,
MedDev Corporation polled the surgeons who use Gold
Eyelid Implants to determine their incidence of
infection and extrusion. The incidence of infection and
extrusion among 168 surgeons reporting on over 2000
cases were 0.3% for infection and 2.6% for extrusion.
This low complication rate is a testament to the
superior quality and design of the MedDev Eyelid
Pickford MA, Scamp T, Harrison DH: Morbidity after gold
weight insertion into the upper eyelid in facial palsy.
British Journal of Plastic Surgery, 45: pp. 460-464,
Does MRI affect Gold Eyelid Implants?
No, JW Canady published an article in
the Annals of Plastic Surgery (31: 76-77, 1993)
reporting on an ex-vivo study which showed no deflection
of the Gold Implants at 0.5 tesla and 1.5 tesla. The
Gold Eyelid Implant is 99.99% pure gold. There are no
ferrous metals in these devices.
An additional study by Mark May
published in Laryngoscope (103: August 1993: p. 93)
reported no magnetic effects from the use of MRI with
the Gold Eyelid Implants but did mention that the
implant may become warm when bombarded with radio waves.
Why is Gold used in manufacturing Eyelid Implants?
Gold is preferred because it is a
heavy, inert metal that does not corrode or cause
irritation to the eyelid tissue. Gold is also preferred
because its color closely matches that of the eyelid’s
fat tissues, making the implant less conspicuous in the
eyelid, even in patients with thin skin. For those few
patients with Gold sensitivity we suggest Platinum as an
What Caret of gold is used?
MedDev’s implants are manufactured
from 24K gold. Prior to production, an independent and
certified laboratory analyzes a sample from each lot of
gold or platinum for purity using an Emission
Spectrophotometer (E-Spec). A broad-spectrum assay is
conducted and all impurities are reported in individual
concentrations. Lot traceability is maintained for all
Eyelid Implants manufactured by MedDev. While analysis
results may vary from lot to lot, no lot is accepted for
production that is not at least 99.99% pure and has
selected trace elements below specified limits.
What is the most popular eyelid weight that is ordered?
The most popular weight for Gold and
Platinum Eyelid Implants are 1.0 and 1.2 grams.
Contact Us or Call MedDev Customer Service at
800.543.2789 (M-F 8:30 am – 5