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K. Kalwerisky, L. Mihora, S. DeMartelaere, D. E. E. Holck; Lower Eyelid Recession Using Spacer Grafts: "To Expose Or Cover". Invest. Ophthalmol. Vis. Sci. 2009;50(13):4827.
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The purpose of this study was to provide an in vivo experimental model to compare host inflammatory response to an interpositional eyelid graft with and without conjunctival coverage. Specifically, we were interested in clinical and pathologic evidence of fibrovascular ingrowth, graft resorption and host inflammatory response to acellular human cadaveric dermis (AlloDerm) vs acellular porcine dermis (Enduragen) using either an externalized approach or internalized approach with conjunctival coverage..
A prospective, nonrandomized clinical study was performed in which surgical placement of either AlloDerm or an equally sized portion of Enduragen was placed into the lower eyelids of twenty two New Zealand White rabbits. Implants measured 10 mm by 15 mm and 1 mm in thickness. Grafts in the exposed group were sutured in place without conjunctival coverage while the non-exposed group was internalized in a conjunctival pocket. Eyelids were examined clinically and histologically at three, six, nine and twelve months postoperatively.
At all time points up to one year after implantation, internalization of graft material resulted in less host inflammatory response, decreased graft resorption and decreased graft vascularization . (Enduragen n=18, AlloDerm n=21).
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