Gore-Tex As An Adjuvant For Prevention Of Symblepharon In Chemical Injury: Our Experience

To assess the efficacy of Gore-tex in preventing the recurrence of symblepharon in patients with post-chemical injuries.

Tertiary Eye Care Hospital, Tirunelveli, Tamil Nadu, India 

A retrospective review of 23 eyes of 22 patients was conducted between January 2014 to December 2021, with a minimum follow-up of 12 months. All patients who underwent symblepharon lysis surgery following chemical injury with Gore-tex were included. Grading of symblepharon done based on the length/ width of symblepharon and loss of palisades of Vogt’s, compared with standard photographs from previous studies. For patients with grade 1, symblepharon release is done with CLAG or AMG along with Gore-tex; for patients with grades 2 & 3, symblepharon release is done with Living related CLAL or CLAG or SLET or AMG and Gore-tex, depending upon the availability of tissue. After the fourth week, Gore-tex was removed.

Results include 23 eyes of 22 patients with a median age of 17 years and a median follow-up of 36 months, the interval between onset of symptom and first presentation in 9 months. Complete success was achieved in 52.1% of eyes, partial success in 34.7%, and 13.04% failed. Success depended upon the length and breadth of the symblepharon. The complications included: Pyogenic granuloma, Spontaneous extrusion of Gore-tex, Recurrence of symblepharon with forniceal shortening & fungal infection of the Gore-tex. The average preoperative BCVA was 1.78 log MAR units & postop BCVA was 0.48 log MAR units; the visual acuity improvement was statistically significant. 

Gore-tex, a synthetic material, acts as a mechanical barrier after symblepharon lysis during the proliferative phase of conjunctival wound healing. In the future, it can act as an adjuvant for preventing fibrosis and Symblepharon in such scenarios.