Amniotic membrane transplantation for congenital distichiasis

To evaluate the use of amniotic membrane transplantation [AMT] for management of congenital distichiasis. In this interventional case series, 16 eyelids of 5 patients with congenital distichiasis underwent posterior lamella resection and AMT. All patients were male subjects with mean age of 13.6 +/- 15.2 [range 2-42] years. Mean follow up was 17 +/- 7.5 [range 6-29] months. Distichiasis did not recur in 11 eyelids [68.7%]. Misdirected eyelashes recurred in 3 eyelids [18.8%] outside the AMT area and in 2 eyelids [12.5%] within the AMT area which were successfully treated by gentle laser epilation. Postoperatively, symptoms of dry eye were controlled by medical treatment in all patients. Eyelid contour was not significantly altered in any patient. AMT seems to be an for surgical management of congenital distichiasis yielding acceptable eyelid contour with low rate of complications

Comparison of two methods for upper lid fascia lata sling in congenital blepharoptosis: a randomized clinical trial

To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function [<4mm] were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling [modified Crawford method] and group B, monotriangular fascia sling [modified Fox method]. This study included 30 upper eyelids [15 eyelids in each surgical group] of 19 patients [8 unilateral and 11 bilateral cases] with congenital ptosis. Mean increase in eyelid fissure height was 2.7 +/- 2.3 mm in group A and 3.4 +/- 2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant [P<0.001, paired t-test] but intergroup difference was not [P=0.4, independent sample t-test]. Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia