Elimination of upper eyelid retraction using a polytetrafluoroethylene implant

Abstract

The purpose is to develop a new technique of eliminating the retraction of the upper eyelid with maximum cosmetic effect duration, retaining eyelid functionality.

Material and methods. The study group included 14 patients (16 eyes), aged 16 to 69 years (45.8 ± 14.4) with upper eyelid retractions. A polytetrafluoroethylene  (PTFE) implant was used as a spacer graft to eliminate the retraction and lengthen the levator. The comparison group was composed of 12 patients (16 eyes) aged 24 to 58 years (41.5 ± 10.4) with upper eyelid retractions, who underwent a surgical intervention consisting of levator mobilization (in some cases, with lateral horns crossing), cutting off the levator from the tarsal plate and refixing with 3–4 sutures with diastasis.

Results. In the study group, the recession value of the upper eyelid corresponded to that calculated prior to surgery. After 1 and 6 months, a positive result was noted, manifesting itself by decreased palpebral fissure and a good cosmetic effect. Lagophthamos  was absent. In the comparison group, the position of the upper lid did not correspond to that expected. Also, hypoeffect progression was observed after 6 months to 2 years after the surgery. A comparative  analysis was conducted  between the elimination of plastic retraction with local tissues and using a PTFE implant.

Conclusion. The proposed method which makes use of PTFE allows obtaining a controlled recession of the levator and achieving a more pronounced and stable effect than in the case when the recession of the levator was achieved by local tissue plastics.