Dr. Alice Kurian, maxillofacial surgery resident at the Amrita School of Dentistry received a best paper award at the recently concluded 16th National Conference of Association of Oral and Maxillofacial Surgeons of India in Mount Abu, Rajasthan.

The paper was titled Gold Weight – The Knight to Rescue: Light, Eyelid Gold Implants in Lagophthalmos.

Lagophthalmos defines the inability of an eyelid to fully close. The condition results from various factors including tumours and trauma. Fortunately one’s ability to open the eye usually remains unaffected.

If not suitably addressed, eyelid paralysis may result in corneal irritation leading to ulceration or even blindness. If initial medical therapy such as lubrication, patching and taping fails, surgical solutions are needed.

Gold weight implantation is a newer surgical method that is gaining popularity for treating the malaise of lagophthalmos. Gold weight implant made of 24-carat pure gold helps in gravity-assisted closure.

Dr. Alice explained this procedure that is also being practiced at Amrita.

“Before loading the eyelid with an implant, we should determine the weight of the implant that would provide optimal lid closure. For this we have to perform a pre-surgical trial with a weight sizing kit supplied by the manufacturers. During this trial, serial increments of gold weights are pasted to the upper eyelid skin using two sided hypoallergenic medical adhesive tape to assess the expected postoperative outcome.”

“An ideal weight would be one that achieves adequate closure of eye. After successful pre-surgical trial, gold implant with the required weight is inserted into the incision made, 4-5 mm above the eyelid margin.”

“The unaffected eyelid elevation mechanism opens the eye, allowing the implanted gold weight to close the eye passively utilizing the force of gravity. This combination of active opening and gravitational closure can be very effective in simulating normal eyelid function.”

“Simplicity of this technique, reversibility and predictable success makes gold weight implantation a clinically proven surgical option for ocular reanimation.”

In case one is wondering why a resident from the School of Dentistry would write a paper on such a technique, Dr. Alice’s explanation is testimony to the inter-disciplinary approach that is embraced in all Amrita schools and campuses.

“Amrita offers a three year residency program in oral and maxillofacial surgery leading to an MDS (Master of Dental Surgery) degree. I am in the final-year of this program and my posting is in the Department of Head and Neck Surgery. I am part of the surgical team there and thus had the opportunity to observe this procedure.”

“In some countries, one can enrol for a masters’ program in maxillofacial surgery only after an undergraduate program in medicine, but in India it is possible after BDS (Bachelor of Dental Surgery) program also. The curriculum includes postings in General Surgery, Anaesthesia, ENT, Head and Neck Oncology, Plastic Surgery and Craniofacial Surgery.”

“Oral and maxillofacial surgery addresses issues of the face, jaws and oral cavity, diseases of facial region, infections like ludwig’s angina which can be life threatening, tumors and cancers of face, oral cavity, tongue, salivary glands and correction of deformities of the face.”

“This branch of oral and maxillofacial surgery is different from other dental specialities in that it needs more background medical knowledge as one is operating upon a patient in a theatre; procedures of most other dental specialties can be performed in a dental clinic.”

We congratulate Dr. Alice for this achievement.

July 21, 2012
School of Dentistry, Kochi