Cerclage technique for dynamic eyelid closure in facial paralysis.

The ophthalmic surgeon's approach to the eyelid problem associated with facial nervc paralysis is by tradition a conservatively static one. A number of procedures have been devised, a standard example of which is the tarsorrhaphy. NMore recently a refreshing new dynamic approach to this disabling condition has arisenl in the continent of Europe. These techniques derived from France attempt to restore the proper synergism of eyelid movement, and to improve cosmesis, while respecting the importance of the tear-film. The palpebral spring invented by MIorel-Fatio is a satisfactory device for restoring lid movement, and has enjoyed considerable success in Europe, North America, and Australia (Morel-Fatio and Lalardrie, I967; Guy and Ransohoff, I968; Smith and Cherubini, I970; English and English, I972; Levine, House, and Hitselberger, I972). However, where there is marked involvement of the lower eyelid, the cerclage technique (Arion, I972) iS to be preferred. This applies also when a palpebral spring has to be removed in the event of erosion or rejection.