Blink assessment must before facial transplant

Careful assessment of eyelid function can improve results of facial transplants that some people undergo after severe facial trauma, shows a study.

"There is no guarantee that the eyelids will function normally after transplantation," said senior author Eduardo Rodriguez from New York University (NYU) Langone Medical Center.

"Careful and methodical preparation prior to facial transplantation, and attentiveness to post-surgical eyelid function, is essential to preserving vision in these cases," Rodriguez added.

The findings underscore the importance of being extremely methodical in assessing eyelid function because loss of the protective blink reflex can not only compromise vision, but lead to blindness over time.

Face transplantation can dramatically enhance a patient's quality of life after severe facial trauma, but lack of attention to eyelid function and vision can leave patients with impaired vision and other eyelid-related complications.

Careful blink assessment is necessary in planning facial transplant procedures, as well as during and after transplant, and post-transplant revision surgeries, the researchers noted.

In the article, the researchers reported on a patient - Richard Lee Norris of Virginia, US -- with a severe injury to the central and lower face caused by a gunshot injury.

"This is the first article addressing blinking in the facial transplant setting," Rodriguez said.

"If you cannot blink, your corneas are susceptible to the extremes of weather and exposure of the corneas while you sleep due to incomplete closure. This ultimately results in painful corneal exposure and potential scarring over part of the pupil which will ultimately impair vision," Rodriguez added.

The study appeared online in the journal Plastic and Reconstructive Surgery.