Comparison of alloplast materials in experimental extraocular muscle surgery.
BACKGROUND
Extraocular muscles may be recessed using implants as spacer material. Silicone retinal band is an example of a spacer used to elongate the superior oblique (SO) tendon in Brown's syndrome and SO overaction; however, complications such as extrusion, scarring and restriction due to the implant have been reported. The purpose of our study was to evaluate and compare fibroblastic and inflammatory reactions to different alloplast materials in a rabbit model.


METHODS
Twenty-three rabbit eyes underwent superior rectus (SR) expander surgery, and 9 eyes SR recession surgery. SR expander surgery was performed using either silicone retinal band (240 style; 6 eyes), polytetrafluoroethylene (Gore-Tex; 10 eyes) or porous polyethylene (Medpor; 7 eyes). Twenty eyes were enucleated at 4 weeks and 12 eyes at 8 weeks and examined by light microscopy. The expression of basic fibroblast growth factor (bFGF) was evaluated by immunohistochemical analysis.


RESULTS
All alloplast materials induced more inflammatory response compared to control eyes (p < 0.05). Medpor induced a markedly stronger inflammatory response than silicone and Gore-Tex (p < 0.05). Gore-Tex and silicone induced similar inflammatory responses. Gore-Tex implants yielded a slightly higher bFGF expression than silicone or Medpor implants (p = 0.07).


CONCLUSIONS
Polytetrafluoroethylene (Gore-Tex) was found to be similar to silicone in its biocompatibility when used as spacer material in extraocular muscle tendon expander surgery. The high bFGF expression observed in Gore-Tex-implanted eyes suggests porous polymers may promote tissue ingrowth into the implant.
Ugurbas
Silay Cantürk
SC
Department of Ophthalmology, Başkent University School of Medicine, Ankara, Turkey. silaycanturk @ gmail.com
Kocer
Nazim Emrah
NE
Oto
Sibel
S
Kahraman
Burcu
B
Akova
Yonca Aydin
YA
D000818:Animals; D001672:Biocompatible Materials; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D005549:Foreign-Body Reaction / Q000378:metabolism / Q000473:pathology*; D009801:Oculomotor Muscles / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D011095:Polyethylenes; D011138:Polytetrafluoroethylene; D011817:Rabbits; D012826:Silicone Elastomers; D013285:Strabismus / Q000601:surgery*; D015625:Tissue Expansion Devices
D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D012826:Silicone Elastomers; D016222:Fibroblast Growth Factor 2; D011138:Polytetrafluoroethylene