Correction of lower eyelid retraction with high density porous polyethylene: The Medpor((R)) Lower Eyelid Spacer

PURPOSE. To describe the use of a new alloplastic implant for the correction of complex lower eyelid retraction. METHODS. A retrospective review of patient charts and photographs was performed to evaluate the efficacy of the first 50 porous polyethylene lower eyelid spacers (LES) used in the correction of complex eyelid retraction. RESULTS. Fifty LES were implanted in 38 patients. Follow-up ranged from 18 to 32 months. The average number of surgical procedures attempted for eyelid retraction repair prior to referral to our practice and implantation of the LES was 5, range 0 to 16. After LES implantation, all patients had improvement of their lower eyelid retraction. Three LES implants were revised for eyelid contour deformity ('lateral winging') and one for exposure through the anterior eyelid margin. In two cases, full-thickness skin grafts were placed directly over the porous implants with good success. DISCUSSION. Lower eyelid spacers (LES) constructed of porous polyethylene provide a rigid, bio-integrated support for eyelids with severe malposition that are recalcitrant to other corrective efforts.