Reconstruction of conjunctival fornices using silicone rubber sheets

A simple procedure is described for reconstructing conjunctival fornices obliterated by severe symblepharon and ankyloblepharon, re-establishing lid movement. After dividing attachments of the lids to the globe and to themselves, a thin sheet of silicone rubber is sutured into the fornices and over the lids. A soft contact lens or scleral shell is worn postoperatively. Epithelialization occurs over denuded surfaces of the reconstituted fornix. The sheets remain in place as long as they are tolerated. Regrowth of symblepharon may not be preventable by this method, but their reappearance can often be postponed for weeks or months.