An Abortive Cryptophthalmos case with surgical treatment

1. Naka Masahiko
2. Satoru Kase
3. Noda Mika
4. Yositsugu Tagawa
5. Susumu Isida

Department of Ophthalmology, Hokkaidou University

Purpose:
To report a case of a one-month-old girl with right side abortive and left side complete cryptophthalmos.

Methods:
The infant was born at term by vaginal delivery following a normal pregnancy and birth weight was 3140 g with no associated systemic anomalies. Family history was non-contributory.
She was first seen with abortive cryptophthalmos in the right and complete in the left. On the right side, the upper eyelid was a coloboma of the medial two-thirds and the upper punctum was absent while the lower eyelid including punctum was normal. Tear function was normal. On the left side, the eye was completely covered with skin. Surgical intervention was performed to create fornices with subsequent upper lid reconstruction for optimizing visual potential.
Beginning in one month of life, upper eyelid was dissected from the cornea, conjunctival fornices was reconstructed with amnion membrane and buccal mucosa and anterior lamellar was reconstructed using the post-auricular skin in a stepwise manner up to 6 month-old.

Results:
Three months after the latest operation, the movement of her right eyelid and the tear function are good and lower half cornea is kept clear.　　　

Conclusions:
Oculoplastic surgery in cryptophthalmos required a stepwise and methodical approach
according to the severity of the abnormality and the potential for vision. We operated an
abortive cryptophthalmos patient at an early age without delay who has a realistic
potential for useful vision.