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Histological Evidence of Tissue Reaction to Platinum Eyelid Chain

WengOnn Chan, MB, ChB; Craig James, MBBS, FRCPA; Peter Sutton-Smith, PhD; Thomas Dodd, FRCPA; Dinesh Selva, FRACS, FRANZCO
Arch Ophthalmol. 2011;129(9):1247-1248. doi:10.1001/archophthalmol.2011.255.
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We read with interest the article by Lockington et al1 on tissue reaction to gold eyelid weights; herein we describe, to the best of our knowledge, the first reported case of symptomatic tissue reaction to a platinum eyelid weight.

An 85-year-old man underwent pretarsal insertion of an upper-eyelid, 1.2-g, platinum-iridium eyelid chain (Spiggle & Theis GmbH, Dieburg, Germany) for exposure keratopathy due to nonresolving Bell palsy. He presented 5 months later with good recovery of orbicularis function but had upper-eyelid pretarsal edema and erythema; there was no significant pain or tenderness. The chain was explanted at 6 months. Intraoperatively, there was fibrosis around the chain and within fixation holes. There were fine black particles seen in tissue adjacent to the chain. The chain appeared well fixated to the tarsus, with no mobility. The pretarsal edema resolved following explantation, and the patient remained free of complications at follow-up 2 months later.

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Figure 1. Mild lymphocytic inflammatory infiltrate associated with dense focally diathermied collagen with deposition of black granules, free-lying and in the cytoplasm of histiocytes and a multinucleate giant cell (arrow) (hematoxylin-eosin; original magnification ×400).

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Figure 2. Trace from energy dispersive X-ray spectrometry showing peak for platinum (Pt).

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