A new conformer design to expand the horizontal lid fissure in severely microphthalmic eyes

Effective treatment of severe microphthalmos requires early placement of conformers to increase the size of the conjunctival sac and to increase orbital dimensions. This process may be confounded by inadequate horizontal lid length and microblepharon. Lateral canthotomy can be used to facilitate early placement of serial conformers, but this procedure is often avoided due to frequent peripalpebral scarring and recurrent phimosis. Conformers currently in use do not separate the lateral lid margins enough to prevent such scarring after lateral canthotomy. We describe a child with severe microphthalmos and microblepharon in whom a novel conformer was used to prevent scarring following lateral canthotomy. Use of this conformer design may make lateral canthotomy a viable option to expand the horizontal lid fissure and facilitate early orbital expansion in patients with severe microphthalmos.