Purchase this article with an account.
R. J. Peralta, B. Lissauer; The Degree of Porcine Acellular Dermal Matrix (enduragen) Contracture Following Lower Eyelid Retraction Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4826.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Spacer grafts are sometimes necessary to provide soft-tissue support in certain cases of reconstructive and primary lower eyelid surgery. Earliest grafts were made of preserved sclera. Autologous grafts ranging from cartilage (ear, nasal and rib), hard palate mucosa, dermis and fascia have more recently been employed. In an effort to circumvent the need to harvest from an autologous donor, alternatives such as human acellular dermis (AlloDerm) or high-density polyethylene (Medpor) have been developed. However, these materials have been wrought with variance in efficacy, permanence and biological tolerance. Recently, porcine acellular dermal matrix (Enduragen) has been deemed a satisfactory substitute, providing comparable strength, rigidity and durability in reconstructive and primary eyelid surgery. Our study aims to expound upon those claims by providing quantitative information on the degree of Enduragen contracture following lower eyelid retraction surgery.
A retrospective chart review was conducted on consecutive cases performed by BL in which Enduragen was used as a spacer graft for reconstructive or primary lower eyelid surgery. Patient demographics, type of procedure performed and date of procedure performed were collected from the pre-operative visit. Margin to reflex distance from the upper and lower eyelid (MRD1 & MRD2, respectively), vertical interpalpebral distance (IPD) and distance from the inferior limbus to the lower eyelid margin were extrapolated from pre-operative photographs. Measurements were made in units of Purkinje images. Measurements of MRD1, MRD2, IPD and distance to inferior limbus were again measured at 1 month and 3-5 months post-operatively in a similar fashion.
23 eyelids of 15 patients were included in the study. Mean increase in MRD2 was 9.6% from 1 month to 3-5 months, with average follow-up of 4.6 months. No patients showed inferior scleral show at the last follow-up visit.
Enduragen spacer grafts are a viable option for lower eyelid retraction surgery, demonstrating less than 10% contracture as measured by MRD2 and distance of lower lid margin to the inferior limbus.
This PDF is available to Subscribers Only