%0 Case Reports
%T Type IV Hypersensitivity to Gold Weight Upper-Eyelid Implant: Case Report and Review of the Literature.
%A Kilduff CLS
%A Casswell EJ
%A Imonikhe R
%A Marjanovic B
%J Ocul Immunol Inflamm
%V 26
%N 6
%D 2018
%M 28471252
%F 3.728
%R 10.1080/09273948.2017.1311922
%X <B>OBJECTIVE: </B>Complications associated with gold-weight insertion for lagophthalmos are uncommon, recent reports have provided evidence to suggest that type IV hypersensitivity to gold can cause a persistent inflammatory reaction.<BR><B>METHODS: </B>We present a case of a 46-year-old man who experienced persistent post-operative inflammation, and summarize previously documented cases. This patient underwent uncomplicated insertion of an upper eyelid gold weight for right-sided facial nerve palsy. He had no allergies or implanted metalwork. Post-operatively erythema was noted at seven-weeks and did not resolve. The weight was removed after six-months.<BR><B>RESULTS: </B>The histopathological findings were in keeping with type IV hypersensitivity and similar to previous cases.<BR><B>CONCLUSIONS: </B>Although infrequent, this complication has poor outcomes. The definitive management is removal of the weight. Information regarding implanted gold, and previous reactions should be elicited pre-operatively. Type IV hypersensitivity should be considered in patients with persistent inflammation that do not respond to antibiotic or steroid therapy.