11/70. Formation of a unilateral form deprivation myopia (FDM) due to a congenital eyelid entropium with a consecutive corneal ulcer: an illustrated case report. Eye growth is regulated by a precise, sharp image of a distant object on the photoreceptor layer. A variety of laboratory investigations report that translucent occluders may induce axial eye elongation in animals. This axial growth is also called form deprivation myopia (FDM). In our pediatric ophthalmology clinic we observed the clinical correlate of FDM in a male infant with unilateral corneal ulcer due to a congenital tarsal malformation. Examination in the postnatal period under anesthesia revealed identical axial length in both eyes. Refraction of the affected eye could not be measured due to severe corneal ulcer. During an observation period of two years, the deep corneal opacification of the affected eye induced unilateral disproportionate axial elongation with formation of myopia. Formation of FDM may complicate treatment of amblyopia following unilateral media opacification. Periodic measurements of refraction should be performed to allow appropriate correction. ( info) |
12/70. Dominant familial congenital entropion with tarsal hypoplasia and atrichosis. BACKGROUND: Congenital entropion and atrichosis of the lower eyelids associated with tarsal hypoplasia is a rare condition, with isolated reports in the literature and without previous pathologic examination. methods: Case report. A father and son with mild entropion, lower eyelash atrichosis, and tarsal hypoplasia are described. A family pedigree demonstrates autosomal dominant inheritance. RESULTS: Histopathology from an entropion repair shows rudimentary tarsus and meibomian glands consistent with hypoplasia of the tarsus. CONCLUSIONS: Isolated congenital entropion may occur in association with atrichosis of the lower eyelashes and hypoplasia of the tarsus as an isolated anomaly. The condition may be inherited as an autosomal dominant trait and appears to be well tolerated. ( info) |
13/70. Severe congenital horizontal tarsal kink without levator aponeurosis disinsertion. A newborn presented with congenital severe tarsal kink of the upper eyelids not caused by levator aponeurosis disinsertion. A bilateral anterior lamellar repositioning procedure was performed to correct the tarsal kink. Levator aponeurosis disinsertion was not observed as an intraoperative finding. The tarsal kink disappeared, and eyelid positions remained stable during a follow-up period of 1 year. Our case indicates that severe congenital tarsal kink may develop without levator aponeurosis disinsertion, and anterior lamellar repositioning technique is a simple and effective method of treatment. ( info) |
14/70. Tarsal kink syndrome associated with congenital corneal ulcer. We describe a case of unilateral upper eyelid horizontal tarsal kink with congenital corneal ulceration. The surgical repair, by means of a simple resection of orbicularis and skin, is presented as a simple technique to correct the congenital anomaly of tarsal kink. Congenital tarsal kink should be included in the differential diagnosis of congenital corneal opacity and ulceration. Early recognition and surgical intervention reduces corneal scarring. ( info) |
15/70. Amniotic membrane transplantation elicits goblet cell repopulation after conjunctival reconstruction in a case of severe ocular cicatricial pemphigoid. PURPOSE: The surgical procedures used until now to rebuild the conjunctiva in patients affected by ocular cicatricial pemphigoid (OCP) have not demonstrated appreciable anatomical and functional success. This study reports the postoperative clinical and cytological outcomes of a human amniotic membrane transplantation (AMT) to rebuild the conjunctiva in a case of late stage OCP. methods: We present a 75-year-old woman with a severe form of pemphigoid with entropion, trichiasis, symblepharon and blunting of the fornices, who underwent excision of the scarred and inflamed tissue covering the ocular surface and AMT. RESULTS: Our data show an improvement of the ocular surface condition, with reacquired fornix depth, reduced inflammation and presence of goblet cells at each follow-up. CONCLUSION: Amniotic membrane transplantation was successful as a first step procedure to reduce inflammation and to rebuild a physiological conjunctival epithelium in late stage OCP. ( info) |
16/70. Autologous allogeneic amniotic membrane grafting in stevens-johnson syndrome. We describe the use of autologous allogeneic amniotic membrane in ocular surface reconstruction. A 28-year-old woman with cicatricial entropion from stevens-johnson syndrome had recurrent keratinization of the tarsal conjunctiva. Amniotic membrane from the patient's own conceptus was stored and successfully used in ocular surface reconstruction with improvement of ocular symptoms. disease transmission is an important risk inherent in all human tissue transplantation. Use of carefully prepared autologous allogeneic amniotic membrane grafts should be considered in pregnant patients in need of ocular surface reconstruction. ( info) |
17/70. Eyelid reconstruction with hard palate mucosa grafts. Hard palate mucosa grafts are an excellent replacement for tarsus and conjunctiva in eyelid reconstruction. Twenty-five eyelids from 18 patients underwent eyelid reconstruction using hard palate mucosa grafts. patients were treated for a variety of disorders including postblepharoplasty lower eyelid retraction, cicatricial entropion, eyelid retraction secondary to thyroid eye disease, and lagophthalmos following surgery for paralytic ptosis. Surgical results were evaluated, grafts were measured for postoperative shrinkage, and donor site healing was recorded. Several patients had hard palate biopsy specimens evaluated. One of these patients also had a graft biopsied after it had been in place for 3 months. A review of hard palate anatomy and histology and a discussion of surgical technique are presented. ( info) |
18/70. trisomy 13: a rare case of congenital tarsal kink. We describe the management of the eyelid anomaly associated with Patau syndrome. trisomy 13 is the genotype of the syndrome's phenotype. The eyelid anomaly was a tarsal kink, a congenital malformation of the tarsus that causes entropion. A 2-month-old white girl presented with unilateral upper eyelid entropion and central corneal ulceration. To correct this condition, two 6-0 polyglactin sutures were passed through the gray line of the upper and lower eyelids and tied. Correction of the entropion and improvement in the corneal condition were achieved after surgery. No recurrence of the entropion or corneal ulceration was noted after 2 months of follow-up. This simple technique, which corrected the eyelid malposition, providing an excellent cosmetic result without incision of the tarsus, has been previously reported in other cases of tarsal kink but not in a patient with Patau syndrome. ( info) |
19/70. Consecutive ectropion after the Wies procedure. PURPOSE: To describe the clinical features and management difficulties of the ectropions after Wies procedure for lower eyelid involutional entropion in 4 patients. methods: Case series. RESULTS: All ectropions had developed within 2 months of the Wies procedure. Common structural features with cicatricial contraction of the anterior lamella and buckling of the tarsal plates were evident. Maximal horizontal eyelid shortening and excision of anterior lamella scar tissue allowed correction. CONCLUSIONS: Consecutive ectropion is caused by secondary cicatricial changes, which can be difficult to manage. Untreated horizontal laxity and postoperative scarring are likely contributory factors in its development. The authors recommend excision of anterior lamella scar tissue combined with large full-thickness wedge excision as an effective treatment. ( info) |
20/70. Two brothers with trichiasis, entropion and corneal scarring, sensorineural hearing loss, progressive thinning of scalp hair, mild learning difficulties and distinct facial features. A new syndrome? Two brothers with very similar phenotypes involving trichiasis (misdirected lashes), entropion with corneal abrasions, strabismus, progressive thinning of the scalp hair, sensorineural hearing impairment, mild learning difficulties, and inguinal hernias are described. They have similar, distinctive facial features with deep-set eyes, a high nasal bridge and a short philtrum. Both brothers are carriers of a maternally inherited apparently balanced translocation of chromosomes 11 and 18: 46,XY, t(11;18)(p13;q21)mat. However, this is thought to be coincidental, since their younger brother also carries this translocation and is phenotypically normal. Although they have many features that are found in the ectodermal dysplasia syndromes, their combination of features is distinct and has to our knowledge not been previously reported. ( info) |