Medpor® Lower Eyelid Spacer: Does it Biointegrate?

Mavrikakis, Ioannis; Francis, N.A.; Poitelea, Cornelia; Parkin, Ben; Brittain, Paul; Olver, Jane

doi:10.1080/01676830802414855

Cited by 20 publications

(13 citation statements)

References 8 publications

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“…If destruction is not an option, the implants get wrapped in a fibrous shroud with sparse or no vascularization, so that it becomes effectively isolated from the surrounding tissue. This is seen in artificial ligaments [8,9], implanted biosensors [10,11], joint implants [12,13], breast implants [14,15], encapsulated tissues/cells [16,17], drug delivery systems [18] and eye implants [19,20], and regularly impairs the proper function of the implant. This has prompted the field to alter surface structures and coatings to contain this problem [5,21-27].…”

Section: Fibrosis - Ubiquitous Problem and Global Burdenmentioning

confidence: 99%

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis _ state of the art

Chen

Raghunath

2009

Fibrogenesis Tissue Repair

121

100

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Fibrosis represents a major global disease burden, yet a potent antifibrotic compound is still not in sight. Part of the explanation for this situation is the difficulties that both academic laboratories and research and development departments in the pharmaceutical industry have been facing in re-enacting the fibrotic process in vitro for screening procedures prior to animal testing. Effective in vitro characterization of antifibrotic compounds has been hampered by cell culture settings that are lacking crucial cofactors or are not holistic representations of the biosynthetic and depositional pathway leading to the formation of an insoluble pericellular collagen matrix. In order to appreciate the task which in vitro screening of antifibrotics is up against, we will first review the fibrotic process by categorizing it into events that are upstream of collagen biosynthesis and the actual biosynthetic and depositional cascade of collagen I. We point out oversights such as the omission of vitamin C, a vital cofactor for the production of stable procollagen molecules, as well as the little known in vitro tardy procollagen processing by collagen C-proteinase/BMP-1, another reason for minimal collagen deposition in cell culture. We review current methods of cell culture and collagen quantitation vis-à-vis the high content options and requirements for normalization against cell number for meaningful data retrieval. Only when collagen has formed a fibrillar matrix that becomes cross-linked, invested with ligands, and can be remodelled and resorbed, the complete picture of fibrogenesis can be reflected in vitro. We show here how this can be achieved. A well thought-out in vitro fibrogenesis system represents the missing link between brute force chemical library screens and rational animal experimentation, thus providing both cost-effectiveness and streamlined procedures towards the development of better antifibrotic drugs.

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Section: Fibrosis - Ubiquitous Problem and Global Burdenmentioning

confidence: 99%

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis _ state of the art

Chen

Raghunath

2009

Fibrogenesis Tissue Repair

121

100

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“…Medpor has the advantage of achieving rapid biointegration much like autologous tissue, but without the need for a harvesting procedure. 8 …”

Section: Commentmentioning

confidence: 99%

“…6 However, the use of Medpor is not without risk, as there are a number of prior reports of infection and inflammation associated with Medpor. 8,9,10 Further studies are therefore needed to fully describe the advantages and complications of Medpor use with Type II KPro.…”

Section: Commentmentioning

confidence: 99%

Use of a Porous Polyethylene Lid Spacer for Management of Eyelid Retraction in Patients with Boston Type II Keratoprosthesis

Sivaraman

Aakalu

Sajja

et al. 2013

Orbit

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Purpose: To report a novel application of a porous polyethylene implant for lid stabilization and management of eyelid retraction in a patient with an exposed Boston Keratoprosthesis Type II. Methods: A 54-year-old woman with a history of mucous membrane pemphigoid and failed penetrating keratoplasty of the left eye underwent implantation of a Boston Keratoprosthesis (KPro) Type II along with permanent surgical fusion of the upper and lower lids of the left eye in January 2010. At one month follow-up, significant retraction of the lower lid around the inferior margin of the optic was noted, resulting in partial exposure of the keratoprosthesis. The patient subsequently underwent left lower eyelid reconstruction with a porous polyethylene implant to ensure coverage and stability of the KPro. Results: Eyelid reconstruction using a porous polyethylene implant resulted in stable retention of the KPro Type II for over 2 years. Conclusion: In patients with Boston KPro Type II in the setting of severe cicatrizing ocular surface disease, the use of a porous polyethylene implant during eyelid reconstruction around the KPro optic may aid in maintaining eyelid integrity and improving KPro stability and longevity.

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“…Other complementary procedures such as reconstruction of the lower fornix, canthopexy, lower eyelid spacer implant and eyelid ptosis correction may be further associated in order to improve the stability of the prosthesis [14][15][16][17]. However, these surgical procedures are often not sufficient to completely solve the enophthalmos, the absorption of fat and subsequent modifications and have the disadvantages to be hugely invasive, surgically complex, involve sutures and scars and have high recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

Lipostructure Plus Platelet Rich Plasma Injections for Enophthalmos Treatment in Patients Carrying Prosthetic Eye- Safety and Efficacy

2017

JOCR

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Purpose: To describe one-year functional and aesthetic outcomes in patients with post-enucleation enophthalmos who underwent lipostructure plus platelet-rich plasma injections. Materials and Methods: 26 patients treated with orbital lipostructure and three platelet rich plasma injections at 1, 2 and 6 months after surgery were retrospectively assessed. Photographs of all patients were taken preoperatively and at 1 and 12 months after surgery. The area of each eye lid esthetic unit/subunit was calculated, both in frontal and profile images. Statistical analysis was performed using SPSS software (SPSS Inc., Chicago, Illinois, USA). Paired t-test was used to compare the unit/subunit areas before and after surgery. Differences were considered significant when P <0.05. Results: Comparing baseline to 1-month images, an improvement of the enophthalmos appearance was observed in all patients. Analysis of each single esthetic units was performed, with an overall unit area reduction of 19.8%. Comparing the two postoperative images, the overall amount of resorption was 12.75%. The surgical procedure appeared to be well tolerated in all cases. Minor complications regarding the lower eyelid were recorded in 6 cases. Conclusions: lipostructure plus platelet rich plasma injections proved to be a valid and effective option for the treatment of post enucleation socket syndrome.

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Medpor® Lower Eyelid Spacer: Does it Biointegrate?

Cited by 20 publications

References 8 publications

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis _ state of the art

Focus on collagen: in vitro systems to study fibrogenesis and antifibrosis _ state of the art

Use of a Porous Polyethylene Lid Spacer for Management of Eyelid Retraction in Patients with Boston Type II Keratoprosthesis

Lipostructure Plus Platelet Rich Plasma Injections for Enophthalmos Treatment in Patients Carrying Prosthetic Eye- Safety and Efficacy

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