title: Medpor lower eyelid spacer: does it biointegrate?
abstract: OBJECTIVE
  To report the histopathologic findings of explanted Medpor lower eyelid spacers (LES) in complicated cases.
  
  
  METHODS
  Four cases of lower eyelid retraction due to thyroid orbitopathy (n = 2), facial nerve palsy (n = 1), and post-enucleation socket syndrome (n = 1) were treated with Medpor LES.
  
  
  RESULTS
  All implants were removed between 6 months to 2 years following their original insertion due to exposure, poor stability, or contour. Histopathology of the implants showed fibrosis and vascularization although clinically, at the time of removal, did not appear vascularized. In addition, immunohistochemistry was positive for Factor VIII related antigen and CD34, thus highlighting the presence of vessels in the pores and around the implant.
  
  
  CONCLUSIONS
  To our knowledge, we are the first to report histopathologic findings of explanted high-density porous polyethylene implants from the lower eyelid in humans. Although this study shows that Medpor LES does biointegrate, we advocate using it sparingly due to associated complications such as exposure, poor stability, and contour.
authors.affiliation: Sussex Eye Hospital, Brighton and Sussex University Hospitals, Brighton, UK. jmavrikakis@yahoo.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mavrikakis
authors.forename: Nick
authors.initials: N
authors.lastname: Francis
authors.forename: Cornelia
authors.initials: C
authors.lastname: Poitelea
authors.forename: Ben
authors.initials: B
authors.lastname: Parkin
authors.forename: Paul
authors.initials: P
authors.lastname: Brittain
authors.forename: Jane
authors.initials: J
authors.lastname: Olver
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation*; D020959:Polyethylene; D011095:Polyethylenes; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*
chemical_list: D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D020959:Polyethylene