Eyelid and fornix reconstruction in abortive cryptophthalmos: a single-center experience over 12 years

PurposeAbortive cryptophthalmos is a rare congenital eyelid anomaly with poor prognosis for vision and cosmesis. The study aims to present its varied manifestations and surgical outcomes.Patients and methodsThe medical records of patients with abortive cryptophthalmos treated at the Oculoplastic Clinic of Beijing Tongren Hospital between January 2004 and May 2016 were reviewed. Early surgical intervention was performed when exposure keratopathy occurs. Upper eyelid and superior fornix were mainly reconstructed with sliding myocutaneous flap and scleral and amniotic grafts. Post-operative upper eyelid contour, recurrence of symblepharon, and ability to retain prosthesis were evaluated.ResultsThe study included 41 eyes of 28 patients. The median age at first presentation was 5 years (ranging from 1 month to 58 years). The majority (79%) with concurrent craniofacial abnormalities tended to be associated with more severe cryptophthalmos. Nine eyes of 9 patients had recurrence of symblepharon. Acceptable functional and cosmetic outcomes were achieved in 20 of the 24 patients receiving repair procedures during the follow-up period.ConclusionOne-stage reconstruction of eyelid and fornix with scleral and amniotic grafts is an effective strategy to correct abortive cryptophthalmos.