Korean J Ophthalmol.  2005 Dec;19(4):247-251. 10.3341/kjo.2005.19.4.247.

Polytetrafluoroethylene as a Spacer Graft for the Correction of Lower Eyelid Retraction

• Lee YJ
• Khwarg SI

• KMID: 754434
• DOI: http://doi.org/10.3341/kjo.2005.19.4.247

Abstract

PURPOSE
To evaluate the efficacy of porous expanded polytetrafluoroethylene (e-PTFE, Goretex (R) ) containing large pores made with a 21-gauge needle as a graft for the correction of lower lid retraction. METHODS: e-PTFE grafts were implanted between the tarsus and lower lid retractor via a transconjunctival approach with/without amniotic membrane transplantation, or via a transcutaneous approach. Rabbits were examined and assessed for corneal and conjunctival complications and for e-PTFE graft status. Rabbits were sacrificed for a histological study at 8 weeks postoperatively. RESULTS: e-PTFE grafts were uniformly extruded 3 weeks postoperatively in eyelids operated on via the transconjunctival approach. However, rabbits operated on via the transcutaneous approach demonstrated e-PTFE graft retention; in addition, dense fibrovascular ingrowths into the large pores of e-PTFE were observed histologically. CONCLUSIONS: e-PTFE is a good substitute for other graft materials as a spacer in lower lid retraction operations, especially as an interpositional graft using a transcutaneous approach.

Keyword

Expanded polytetrafluoroethylene (e-PTFE) ; Lower lid retraction; Lower lid retraction repair

MeSH Terms

Treatment Outcome
Rabbits
*Prosthesis Implantation
Prosthesis Design
Prostheses and Implants
*Polytetrafluoroethylene
Eyelids/pathology/surgery
Disease Models, Animal
Blepharoptosis/pathology/*surgery
Blepharoplasty/*methods
Biological Dressings
Animals

Figure

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  Fig. 1 Photograph of e-PTFE with pores made using a 21-gauge needle (15 mm×4 mm).

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  Fig. 2 Dissection of lower eyelid through transconjunctival incision. (A) Conjunctiva and lower eyelid retractors were detached from the inferior tarsal border and recessed inferiorly. (B) e-PTFE sewn into place between the inferior tarsal border and recessed lower lid retractors. (C) Amniotic membrane was implanted over e-PTFE.

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  Fig. 3 Dissection of lower eyelid through subciliary cutaneous incision. (A) Lower eyelid retractors were detached from the inferior tarsal border and recessed inferiorly. (B) Several interrupted 6-0 polygalactin sutures were used to secure the e-PTFE to the inferior tarsal margin.

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  Fig. 4 Conjunctival injection and corneal opacity were observed at 2 weeks after transconjunctival e-PTFE implantation.

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  Fig. 5 (A) Cellular and fibrous ingrowth into the e-PTFE (×200, H&E staining). (B) Dense fibrovascular ingrowth fills this pore (*), which was made using a 21-gauge needle (×40, H&E staining).

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