rss
Br J Ophthalmol 2004;88:1197-1200 doi:10.1136/bjo.2003.029397
  • Clinical science
    • Extended reports

The use of porous polyethylene (Medpor) lower eyelid spacers in lid heightening and stabilisation

  1. J Tan1,
  2. J Olver2,
  3. M Wright3,
  4. R Maini2,
  5. C Neoh1,
  6. A J Dickinson1
  1. 1Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2Western Eye Hospital, London, UK
  3. 3Velindre NHS Trust, Cardiff, UK
  1. Correspondence to: A Jane Dickinson Eye Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK; Jane.Dickinsonncl.ac.uk
  • Accepted 14 January 2004

Abstract

Background/aims: The management of lower eyelid retraction can be challenging, and established techniques to correct it are not always successful. Previous reports have suggested a role for the ultrathin high density porous polyethylene lower eyelid spacer (Medpor LES) in such patients. The authors report the experience of three surgeons implanting Medpor LES over 1 year, and ascertain whether such implants are a safe and effective alternative to autogenous spacers.

Methods: A prospective, interventional, non-comparative case series of consecutive patients. Surgical indications for Medpor LES were noted. Preoperative and postoperative lower marginal reflex distance (L-MRD), vertical palpebral aperture (PA), lagophthalmos, and scleral show inferior to the limbus (LSS) were recorded, together with major and minor complications.

Results: 32 patients (35 eyelids) had a Medpor LES inserted, 22/32 under local anaesthetic, and nine with adjunctive procedures. Mean follow up was 22 months (range 15–28 months). The Medpor LES was effective in reducing the palpebral aperture (p<0.001) and lagophthalmos (p = 0.04) and raising the lower eyelid height by reducing both L-MRD (p  =  0.006) and LSS (p<0.001). However there were major complications in 7/32 patients and minor complications in 8/32, most requiring further surgery. Final outcome was good in 24/35 eyelids and satisfactory in 5/35.

Conclusions: Despite a good or satisfactory final outcome in the majority of patients, the value of this technique is limited by complications, and should be reserved for those unsuitable for safer techniques.

Footnotes

  • Conflicting interests: none.

  • This paper was presented in part at the meetings of the British Oculoplastic Surgery Society, Manchester, May 2002, and the European Society Ophthalmic Plastic Reconstructive Surgery, Munster, September 2002.

Responses to this article

  • Response to Professor Bajaj
    • A Jane Dickinson,
    • Jennifer Tan, Jane Olver, Raj Maini, Christopher Neoh
    Br J Ophthalmol published online September 14, 2009
  • A Perspective on Porous Polyethylene Lower Lid Spacers
    • Mandeep S. Bajaj,
    • Neelam Pushker, Ramamurthy Balasubramanya and Sanjiv Gupta
    Br J Ophthalmol published online September 14, 2009

This Article

  1. Abstract
  2. Full text
  3. PDF

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.