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Medpor lower eyelid spacer: does it biointegrate?
Ioannis Mavrikakis1, Nick Francis, Cornelia Poitelea
1Sussex Eye Hospital, Brighton and Sussex University Hospitals, Brighton, UK. jmavrikakis@yahoo.com
Purpose:
To report the histopathologic findings of explanted Medpor lower eyelid spacers (LES) in complicated cases.
Materials And 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.
Conclusion:
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.
Insights
Histopathologic analysis of explanted Medpor lower eyelid spacers (LES) reveals biointegration with fibrosis and vascularization. Despite this, complications like exposure and poor contour suggest cautious use of these implants.
Area of Science:
- Ophthalmic plastic surgery
- Biomaterials science
- Histopathology
Background:
- Lower eyelid retraction presents significant reconstructive challenges.
- Medpor lower eyelid spacers (LES) are utilized for correction.
- Limited histopathologic data exists for explanted Medpor LES.
Observation:
- Four cases of Medpor LES explantation are presented.
- Indications included thyroid orbitopathy, facial nerve palsy, and post-enucleation socket syndrome.
- Implants were removed 6 months to 2 years post-insertion due to complications.
Findings:
- Histopathology revealed fibrosis and vascularization within explanted Medpor LES.
- Immunohistochemistry confirmed vascularization via Factor VIII and CD34 markers.
- Clinical appearance at explantation did not always correlate with vascularization.
Implications:
- Medpor LES demonstrates biointegration potential in the lower eyelid.
- Complications such as exposure, instability, and contour issues necessitate judicious use.
- Further research is needed to optimize outcomes with porous polyethylene implants.
