Reconstruction of Congenital Lid defects

Muhammad Moin

Quaid e Azam Medical College, Bahawalpur, Pakistan

Purpose: To evaluate the difficulties in congenital lid defect repairs.

Methods: Retrospective case series review of 10 patients operated during the last 5 yrs. All patients with congenital lid defect were included. These included patients with colobomas of upper or lower lid and abortive cryptophthalmos. Reconstruction was done using rotation flaps or lid sharing procedures by a single surgeon.

Results: Four patients underwent direct closure, 4 patients underwent Tenzel flap, 1 underwent composite graft, 1 had cutler beard flap. There were 3 patients with abortive cryptophthalmos who underwent mucous membrane graft or conjunctival advancement. Seven patients had satisfactory results post-op. 3 patients had dehiscence of wound after surgery which required further reconstruction. Exposure keratopathy due to delayed presentation was seen in 3 patients while cornea was scarred in 3 cases of cryopthalmos. Mild upper lid notch was seen in 4 cases. Mild upper lid symblephron was seen in 3 cases.

Conclusion: Early surgery with adequate advancement for closure is the key to good results.