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

Purpose: To evaluate the efficacy of porous expanded polytetrafluoroethylene (e-PTFE, Goretex？？) 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. Korean Journal of Ophthalmology 19(4):247-251, 2005