LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
01-646
0305-7518/11/064053+07
10.47276/lr.82.3.279
Original Papers
Efficacy of Temporalis Muscle Transfer for correction of lagophthalmos in leprosy
KumarJulius
aKarthikeyanG.
aRaoP. S. S.
ba
TLM Community Hospital Naini, Allahabad, Uttar Pradesh, India
b
TLM RRC, Noida, Uttar Pradesh, India
Correspondence to: Premal Das, Surgeon & Superintendent, The Leprosy Mission Hospital, Naini, Allahabad – 211 008, Uttar Pradesh, India (e-mail: tlmnaini@tlmindia.org; premal.das@tlmindia.org)
01092011
82
3
279
285
28072011
© Lepra
2011
Objectives:
Temporalis Muscle Transfer (TMT) is a surgical technique used to correct lagophthalmos in leprosy patients. We have evaluated the degree of success of TMT in achieving full lid closure, which is important in preventing damage to the cornea.
Subjects and Methods:
A retrospective study was carried out on 69 patients who had TMT done, at one centre, on 101 eyes during the period of 1998–2009. Lid gaps on direct gaze and with both gentle and forced closure, as well as voluntary muscle testing of eye lid closure, were assessed using standard measuring techniques by a qualified physiotherapist. Associated problems due to lagophthalmos were recorded both pre- and post- operatively. Data were abstracted on to a special proforma and subjected to statistical analysis using SPSS.
Results:
On completion of post-operative physiotherapy, 85% of the eyes could achieve full lid closure with no measurable gap. The mean (SD) lid gap on forced closure was 4.8 (2.8) mm pre-operatively and 0.2 (0.5) mm at the end of the in-patient stay. The mean (SD) lid gap on gentle closure was 7.9 (2.6) mm preoperatively and 2.4 (1.8) mm post-operatively. The mean (SD) vertical inter-palpebral distance, during straight gaze, was reduced from 12.6 (1.6) pre-operatively to 9.8 (1.2) postoperatively. Exposure keratitis cleared in 16 of 27 eyes (60%) and Epiphora cleared or improved in 31 eyes.
Conclusions:
It is concluded that the TMT is a successful option (cosmetically and functionally) for correction of lagophthalmos.