The Nictavi Tarsus Patch: A New Device for Achieving Temporary Eyelid Closure in Lagophthalmos

Sarah Guo,1 Mark S Borchert,2,3 Melinda Chang,2,3 Sudha Nallasamy,1– 3 Mark W Reid,2,3 Sandy Zhang-Nunes,1,3 Jessica R Chang,1,3 Angeline M Nguyen1– 3 1Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 2The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA, USA; 3Roski Eye Institute at the University of Southern California, Department of Ophthalmology, Los Angeles, CA, USACorrespondence: Angeline M Nguyen, Tel +1 323-361-2347, Fax +1 323-361-9812, Email angnguyen@chla.usc.eduPurpose: To evaluate the effectiveness, tolerability, and safety of the Nictavi Tarsus Patch™ (NTP) in inducing temporary eyelid closure for the management of lagophthalmos in the pediatric and young adult population.Methods: We prospectively enrolled 20 patients < 21 years of age who had previously been managed for lagophthalmos to trial the NTP in clinic. Inter-palpebral fissure distance (IPFD) was compared before and after the placement of the NTP in the eyes-closed position using paired t-tests. Subjects then underwent a 3-night home trial with the NTP, and parent and subject perceptions of effectiveness, comfort, and complications with the patch were analyzed using Likert scale survey questions.Results: Twenty subjects ages 2– 20 years with paralytic (65%) and non-paralytic (35%) lagophthalmos were enrolled. The NTP improved lagophthalmos from a mean pre-placement IPFD of 3.3 mm to post-placement IPFD of 0.4 mm (p < 0.01). Overall, 80% of subjects achieved successful eyelid closure defined as ≤ 1 mm of post-placement IPFD. When stratified by subtype, 100% of subjects with paralytic lagophthalmos achieved successful eyelid closure compared to 71% of subjects with non-paralytic lagophthalmos. On a scale of 1 (worst) to 5 (best), parents rated the NTP at 4.3± 0.7 for comfort while wearing, 4.3± 1.0 for comfort in removing, 4.6± 0.7 for ease of use, and 4.3± 0.9 for effectiveness. Ninety-three percent of parents reported preferring NTP to other eyelid closure methods previously tried and indicated that they would use it again.Conclusion: The NTP is an effective, tolerable, and safe method of eyelid closure for children and young adults.Keywords: lagophthalmos, eyelid closure, Nictavi Tarsus Patch, pediatric