아래눈꺼풀뒤당김 교정수술시 이식재료로서 폴리프로필렌 부직포의 이용에 관한 연구

A Polypropylene Sheet as a Spacer Graft for the Correction of Lower Eyelid Retraction

Purpose: To evaluate the usefulness of a polypropylene non-woven sheet as a spacer graft for the correction of lower lid retraction Methods: Fifteen New Zealand white rabbits were randomized into three groups. Polypropylene non-woven sheets were implanted between the tarsus and lower lid retractor via a transcutaneous approach (Group 1), a transconjunctival approach (Group 2), or a transconjunctival approach with amniotic membrane transplantation (Group 3). Numerous large pores were made in the sheet with a 21-gauge needle before implantation. Rabbits were sacrificed serially after 1, 2, 4, 6, and 8 weeks in each group. Gross and histologic examinations were performed. Results: In Group 1, the polypropylene sheets stayed in place well, without any exposure on gross observation except at 2 weeks. In Group 2, the conjunctival wound was not healed on the polypropylene sheet, and the sheet was exposed to the ocular surface and extruded gradually. In Group 3, the conjunctival wound was well healed on the surface of polypropylene sheet, and the sheet remained stationary at 4, 6, and 8 weeks on gross examination. Histologic examinations showed gradual fibrovascular ingrowth into the polypropylene sheets in Groups 1 and 3, but not in Group 2, in which only severe inflammatory infiltrations were observed. Conclusions: The polypropylene non-woven sheet is a good candidate for a spacer material in lower lid retraction operation, and either the transcutaneous approach or the use of an amniotic membrane is necessary for best postoperative outcome.