Ergebnisse nach Lidgewichtimplantation mit starren Goldgewichten - eine Metaanalyse

 

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Zusammenfassung

Einleitung: Zur operativen Therapie des Lagophthalmus kommen starre Goldimplantate zur Anwendung. Es existieren zahlreiche Studien nach Implantation von Goldgewichten mit sehr unterschiedlichen postoperativen Komplikationsraten, wobei in den Primärstudien oft sehr geringe Patientenzahlen vorhanden sind. Ziel unserer Untersuchung war daher, die postoperativen Ergebnisse und Komplikationen nach Implantation starrer Goldgewichte mit den statistischen Mitteln einer Metaanalyse zu untersuchen. Material und Methoden: Es wurden 38 Veröffentlichungen, die über 1000 Implantationen von starren Goldgewichten umfassen, im Rahmen einer Metaanalyse zu den postoperativen Ergebnissen und Komplikationen analysiert. Ergebnisse: Mit den starren Goldimplantaten kann in 84,5 % ein vollständiger Lidschluss erreicht werden. Die postoperativen Komplikationsraten betrugen in 13,4 % Konturierung, 6,4 % Migration, 6,8 % Extrusion, 11,5 % Hornhautastigmatismus und 7,0 % postoperative Infektionen. Diskussion: Die Lidgewichtimplantation ist ein sehr einfaches und reversibles Verfahren zur operativen Therapie des Lagophthalmus. Die statistische Auswertung der in der Literatur vorhandenen Daten bei starren Goldimplantaten ergibt allerdings nicht unerhebliche postoperative Komplikationsraten. Zur Steigerung der Effektivität der Behandlungsmethode sollten diese Ergebnisse Anlass sein, Implantatalternativen zu erwägen.

Abstract

Introduction: For the surgical therapy of lagophthalmos rigid gold implants were used. There are a lot of studies using rigid gold implants with widely different complications. In the primary study the small amount of patients is often a problem. The aim of our study was to survey the postoperative results and complications after insertion of rigid gold implants and to statistically compare the results with a meta-analysis. Material and methods: 38 publications on 1000 rigid gold implants were analyzed in the context of a meta-analysis of the postoperative results. Results: Complete lid closure can be obtained in 84.5 % with the rigid gold implants. The postoperative complication rates were 13.4 % for bulging, 6.4 % for migration, 6.8 % for extrusion, 11.5 % for corneal astigmatism and 7.0 % postoperative infections. Discussion: Lidloading is a very simple and reversible procedure for the surgical treatment of lagophthalmos. The statistical analysis in using rigid gold implants showed a significant rate of postoperative complications. To increase the effectivity of the treatment method these results should be taken into account for alternative implants.

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PD Dr. med. Thomas Schrom

Klinik für Hals-, Nasen-, Ohrenkrankheiten
Charité Campus Mitte

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10117 Berlin

Email: thomas.schrom@gmx.de