urgical trategie for Fornix Recontruction Baed on ymblepharon everity Original Reearch Article

Purpoe To identify urgical trategie of fornix recontruction for ymblepharon graded according to the length from the limbu to the lid margin, to the width, and to aociated inflammation. Deign Retropective, comparative, interventional cae erie. Method In 61 eye with ymblepharon, cicatrix lyi and amniotic membrane tranplantation (AMT) were performed with uture (n = 34) or fibrin glue (n = 27) together with (n = 47) or without (n = 14) intraoperative mitomycin C (MMC), plu fornix recontruction uing anchoring uture without (n = 30) or with (n = 7) oral mucoal graft or with conjunctival autograft (n = 4). Overall, ucce wa defined a an outcome of complete ucce (retoration of an anatomically deep fornix) or partial ucce (focal recurrence of car), and failure wa defined a the return of ymblepharon. Reult For a follow-up of 25 ± 10.8 month, the overall ucce wa achieved by the firt attempt in 52 eye (85.2%) and failure reulted in nine eye (14.8%); however, the ucce rate improved to 59 eye (96.7%) with additional attempt. At the firt attempt, AMT alone achieved overall uccee in 92.8% of grade I eye and in 100% of grade II eye. Additional anchoring uture achieved uccee in 100% of grade I eye, 70% of grade II eye, and 71.4% of grade III/IV eye. Additional oral mucoa or conjunctival autograft achieved uccee in 100% of grade III/IV eye. The complete ucce wa correlated poitively with lower grade of ymblepharon or intraoperative ue of MMC, but negatively correlated with younger age, canthal involvement, or ue of anchoring uture. Anatomic improvement wa accompanied by reduction of preoperative conjunctival inflammation (n = 40), improved viual acuity (n = 14), improved ocular motility (n = 18), improved eyelid cloure (n = 3), and feaibility of contact len wear (n = 10). Concluion ucceful outcome can be achieved by electively deploying cicatrix lyi and AMT, intraoperative MMC, anchoring uture, and oral mucoal or conjunctival autograft baed on the everity of pathogenic ymblepharon. Article Outline