Surgical applications of expanded polytetrafluorethylene in ophthalmology: A review

Expanded polytetrafluoroethylene (ePTFE) has evolved from its origins as an industrial polymer into a biomedical material with a range of demonstrated uses across cardiovascular, hernia repair, and ophthalmology. Its application in ophthalmology has expanded significantly over the past few years owing to its unique physical and chemical properties, including its biocompatibility, inertness, bio-integration, mechanical and chemical stability, high tensile strength, and softness. The earliest ophthalmic applications of ePTFE focused on corneal perforation repair and keratoprosthesis scaffolds, followed by its use in ocular surface reconstruction, scleral buckling, and eyelid procedures. In current products under development, ePTFE has demonstrated unique capabilities in a novel keratoprosthesis and a novel glaucoma shunt. Modifications tailored for ophthalmic applications were made to the ePTFE to optimize pore size for bio-integration, reduce thickness and profile, and incorporate hydrophilic coating to enhance tissue integration and cosmesis. The modifications promise to combine the best attributes of ePTFE engineered to address unmet needs in ophthalmology. Continued clinical trials and translational research are essential to expand its safety and efficacy profile. We provide an up-to-date overview of the physicochemical properties and surgical uses of ePTFE in ophthalmology.