[Correction of lower eyelid retraction with a porous polyethylene (Medpor) lower eyelid spacer--Medpor spacer in lower eyelid retraction].
BACKGROUND
The correction of lower eyelid retraction remains a challenge with established techniques having disadvantages. A recently described alternative is implantation of an ultrathin high density porous polyethylene lower eyelid spacer (Medpor LES). We report our experience on implanting this Medpor LES, especially in patients with lower eyelid retraction due to Graves' orbitopathy.


METHODS
All patients receiving a Medpor LES between March 2003 and November 2004 in the Rotterdam Eye Hospital were included. Indications and preceding procedures as well as the degree of proptosis were noted. Preoperative and postoperative lower eyelid retraction were compared by measuring scleral show inferior to the limbus (LSS). Postoperative complications, recurrent retraction and secondary surgical procedures were recorded.


RESULTS
Out of 12 patients (16 eyelids) in whom a Medpor LES was inserted 8 patients suffered from Graves' orbitopathy. Mean follow-up was 7.5 months (range 4 - 11 months). Final cosmetic outcome was good in 8/16 eyelids and improved in 7/16 eyelids. Lower eyelid retraction (LSS) was reduced significantly (1.34 mm +/- 0.214 (mean +/- std. error of mean), p = 0.004). Complications included eyelid contour deformity (4/16 eyelids), remaining irritation of the eye (1/16) and problems in down gaze (4/16) as well as recurrent lower eyelid retraction (2/16) requiring further surgery in 3 of 11 patients.


CONCLUSIONS
In selected patients, insertion of a Medpor lower eyelid spacer may be a good alternative to correct lower eyelid retraction.
de Jong-Hesse
Y
Y
Okuloplastische Abteilung, Het Oogziekenhuis Rotterdam (The Rotterdam Eye Hospital), 3000 LM Rotterdam, The Netherlands.
Paridaens
D A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D019882:Blepharoplasty / Q000295:instrumentation* / Q000379:methods; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011095:Polyethylenes; D016062:Porosity; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes