Symptomatic and Histological Tissue Reaction to Upper Eyelid Platinum Weight

Objectives: To present a case of non-infectious platinum eyelid weight rejection, the first reported case in otolaryngology literature. Methods: A case of a non-infectious tissue reaction to a platinum eyelid weight was identified. Results: A platinum eyelid weight was placed in a 72-year-old female for paralytic lagophthalmos. The patient presented with persistent edema and skin discoloration on post-operative day 8, though no drainage, tenderness, or other signs of infection were present. The weight was eventually explanted with rapid resolution of symptoms. Pathology demonstrated granulomatous inflammation with histiocytosis and foreign-body giant cells, consistent with tissue reaction to the platinum weight. Conclusions: Platinum eyelid weights are commonly used to treat paralytic lagophthalmos. While non-infectious tissue reactions to platinum are less common than with gold weights, they are still possible and should be treated with weight removal.