Two-stage reconstruction for eyelid deformities in partial cryptophthalmos

Area of Science:

• Ophthalmology
• Plastic Surgery
• Genetics

Background:

• Cryptophthalmos is a rare congenital syndrome characterized by eyelid and eyebrow coloboma and a rudimentary ocular bulb.
• Fraser syndrome is a complex condition that includes cryptophthalmos and other multiple anomalies.
• Limited surgical techniques exist for correcting cryptophthalmos anomalies.

Purpose of the Study:

• To present a surgical procedure for correcting upper eyelid and ocular bulb anomalies in cryptophthalmos.
• To evaluate the efficacy of Mustardé's technique in upper eyelid reconstruction for cryptophthalmos.

Main Methods:

• Retrospective review of five patients diagnosed with Fraser syndrome between 1993 and 2008.
• Four patients underwent upper eyelid reconstruction using a two-stage procedure.
• Mustardé's technique was employed, involving fixation of a transposed lower eyelid flap to the levator muscle.

Main Results:

• Successful treatment of large upper eyelid coloboma and cutaneous pterygium was achieved.
• Good aesthetic and functional results were obtained with Mustardé's technique.
• The surgical approach facilitated relatively good upper eyelid motility.

Conclusions:

• Surgical correction of cryptophthalmos is complex, especially when ocular bulb preservation is not possible.
• Mustardé's technique, with specific flap fixation, offers favorable upper eyelid motility.
• Adequate upper fornix reconstruction is crucial for optimal prosthetic fitting and improved aesthetic/functional outcomes.