Surgical approaches to congenital upper eyelid coloboma: A retrospective case series
Author: Modupe Adetunji
Base Hospital / Institution: Department of Ophthalmology, Duke University Medical Center
ePoster presentation
Abstract ID: 24-461
Purpose
Eyelid colobomas are uncommon congenital malformations caused by failure of fusion of the mesodermal lid folds. The necessity and timing of surgical intervention varies depending on the phenotypic presentation. For upper eyelid coloboma, urgent surgical repair may be needed due to the serious adverse consequences of corneal exposure, which may lead to corneal ulceration and blindness. The purpose of this study was to describe the surgical management and treatment of patients with congenital eyelid colobomas who presented to the oculoplastics service at a tertiary care institution.
Methods
A retrospective case series was performed including patients with congenital upper eyelid colobomas presenting for surgical management. A detailed clinical history was obtained in all patients, including information on personal and family history as well as a complete ophthalmic examination before and after treatment. Initial examination was conducted to evaluate visual acuity, site, size of the eyelid defect, ocular motility, associated ocular abnormalities, and other facial or systemic abnormalities.
Results
Three patients were included, with an age range between 3 months and 4 years with an average age of 27.3 months. All were female. All cases had isolated unilateral upper eyelid colobomas without skeletal involvement. The cases with defects involving ½ of the eyelid were repaired with direct closure with a lateral canthotomy and superior cantholysis, and one case required a Tenzel flap. A case with a smaller defect was repaired with direct closure and an O-to-T flap. Cosmetically acceptable results were achieved in all patients undergoing surgical intervention.
Conclusion
Congenital upper eyelid coloboma is an uncommon anomaly which may be associated with other ocular and systemic disorders. In the current study, all the patients with eyelid colobomas presented with defects of ¼ to ½ of the eyelid length, and all were repaired with direct closure. Satisfactory cosmetic and functional outcomes can be achieved if meticulous preoperative and intraoperative planning is employed.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Julie | Woodward | Department of Ophthalmology, Duke University Medical Center |
| Jason | Liss | Department of Ophthalmology, Duke University Medical Center |
