Polytetrafluoroethylene Sheet Exposure and Lagophthalmos Triggered by COVID-19 Vaccination

We report a rare case of a delayed inflammatory reaction associated with coronavirus disease 2019 (COVID-19) vaccination resulting in polytetrafluoroethylene (PTFE) sheet exposure and lagophthalmos. A 61-year-old man had undergone bilateral frontalis suspension with PTFE sheets for blepharoptosis 3 years earlier. After multiple doses of mRNA COVID-19 vaccines (Moderna and Pfizer), the patient developed progressive eyelid swelling, redness, and subsequent exposure of the PTFE sheets in the sub-eyebrow area. Surgical removal of the PTFE material created a skin defect, which was reconstructed using an artificial dermis. After 2 weeks, full-thickness skin grafts from both lower eyelids were performed on the area. No recurrence occurred after PTFE removal, despite additional vaccinations and COVID-19 infection. These findings suggest that mRNA vaccination may trigger a delayed inflammatory response around synthetic materials, leading to capsule contraction and implant exposure. Awareness of this potential for such reactions is important when evaluating late post-implantation complications.