Chonnam Med J.  2010 Dec;46(3):195-198. 10.4068/cmj.2010.46.3.195.

Surgical Correction of Lid Retraction with a Silicone Sponge in Congenital Fibrosis of the Extraocular Muscles

• Heo H
• Yoon KC
• Park YG
• Park SW

• KMID: 2116776
• DOI: http://doi.org/10.4068/cmj.2010.46.3.195

Abstract

A 5-year-old boy who was diagnosed with congenital fibrosis of the extraocular muscles (CFEOM) presented with bilateral lower eyelid retraction after strabismus surgery. To correct the lower eyelid retraction, a silicone sponge was used as a spacer; it was sutured to the inferior border of the tarsus and the lower eyelid retractor. At the 3-month postoperative visit, both lower eyelid margins were at the inferior corneal limbus. No complications or recurrence was noted at 1 year after surgery. The silicone sponge served as a good spacer for correction of lower lid retraction after strabismus surgery in a child with CFEOM.

Keyword

Eyelid; Fibrosis; Oculomotor muscles; Silicones

MeSH Terms

Animals
Ankle
Child
Eyelids
Fibrosis
Humans
Limbus Corneae
Muscles
Oculomotor Muscles
Porifera
Preschool Child
Recurrence
Silicones
Strabismus
Silicones

Figure

• 

  Fig. 1 (A) Photographs before strabismic surgery showing both eyes fixed in a downgaze with exotropia and gaze limitation in all directions. (B) Both eyes showed lower lid retraction after large inferior rectus disinsertion.

• 

  Fig. 2 Intraoperative photographs. (A) After horizontal dissection of the inferior conjunctival fornix with a monopolar coagulator, the lower eyelid retractor was separated from the lower tarsal plate, and further orbital fat pad dissection was performed. (B) and (C) silicone sponge was inserted between the inferior tarsus and the lower eyelid retractor and was sutured to the inferior border of the tarsal plate (black arrow) and the lower eyelid retractor (black arrow head) with 6-0 Vicryl. (D) Tenon's capsule and conjunctiva were sutured over the silicone sponge, respectively.

• 

  Fig. 3 (A) The photograph shows bilateral lower lid retraction before the operation, using a silicone sponge as a spacer. (B) The 1-year postoperative photograph shows both lower eyelid margins at the inferior corneal limbus in the primary position and good cosmesis.

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