A case of bilateral cryptophthalmia and euryblepharon with two-stage reconstruction.

PURPOSE: A two-stage reconstruction of cryptophthalmia and euryblepharon occurring in the same patient is described. METHODS: Case report. RESULTS: The 7-month-old patient underwent forniceal reconstruction and upper eyelid reformation in a two-stage procedure that used the excess lower eyelid tissue present in euryblepharon to augment the cryptophthalmia-related upper eyelid deficiency. CONCLUSIONS: To reconstruct the eyelids of this patient with both cryptophthalmia and euryblepharon, we were able to use the manifestations of one disorder to address the deficiencies of the other.

Orbital development after enucleation in early childhood.

PURPOSE: To identify growth retardation in the orbits of children who have undergone enucleation and orbital implantation. METHODS: Children who underwent unilateral enucleation for retinoblastoma were examined. Any patient who had received external beam radiation or chemotherapy was excluded. Follow-up time was 5.5 to 10 years (mean, 8.33 years). Several linear measurements were made on the enucleated orbit and the fellow orbit. These measurements were compared using the paired Student t test and multivariate analysis of variance. RESULTS: There was no statistically significant difference in any of the measured orbital dimensions between the enucleated and fellow orbits. CONCLUSIONS: Enucleation in children, when combined with a large orbital implant, does not cause orbital growth retardation.

Reassembly of corneal epithelial adhesion structures after excimer laser keratectomy in humans.

OBJECTIVE: To determine the pattern of long-term reformation of the adhesion structures after excimer laser phototherapeutic keratectomy. METHODS: Four corneal buttons were removed at penetrating keratoplasty 6 to 15 months after initial excimer laser phototherapeutic keratectomy. Morphometric analysis of electron micrographs of the wound bed was performed to determine the extent and pattern of reformation of hemidesmosomes, anchoring fibrils, and basal laminae. RESULTS: Eight percent of the basal epithelial cells had underlying normal anchoring fibrils at 6 months, compared with 35% at 15 months. The percentage of basal cell membrane occupied by hemidesmosomes remained fairly constant (35.2% to 37.7%). With the exception of a localized area of multilamination seen at 9 months, the cross-sectional area of basal lamina per 100 microns of basal cell membrane increased with the duration of wound healing (18.0 microns 2 at 6 months, 24.4 microns 2 at 15 months) but remained below normal levels (32 microns 2). CONCLUSIONS: These data suggest that after human excimer keratectomy, the anchoring fibrils and basal lamina do not completely normalize even after 15 months.