Efficacy of temporalis muscle transfer for correction of lagophthalmos in leprosy.

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 48 (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.