Craniofacial Unit, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Ophthalmic Plast Reconstr Surg. 2010 Nov-Dec;26(6):450-3. doi: 10.1097/IOP.0b013e3181d9293a.
To describe a patient with Tessier cleft number 5 and 9 and review the literature on the ocular impairment and management of this extremely rare anomaly.
Interventional case report and literature review.
The literature review showed that the present patient is the second case with clefts 5/9. The ophthalmic consequences of this rare association are virtually unreported. Our case demonstrates that the presence of cleft number 9 adds a cicatricial component on the upper eyelid that severely impairs the dynamics of this lid. The corneal status of the patient was successfully managed with simultaneous upper eyelid lengthening and facial reconstruction.
In order to avoid corneal perforation, simultaneous upper and lower eyelid reconstruction is mandatory in cases of cleft 5/9. The affected patients should be continuously followed in order to prevent amblyopia.
描述 1 例 Tessier 裂隙 5 号和 9 号患者，并复习关于该极其罕见畸形的眼部损害和处理的文献。
介入性病例报告和文献复习。
文献复习表明，本例是第 2 例 5/9 号裂隙患者。该罕见畸形的眼部后果几乎未见报道。本病例表明，9 号裂隙的存在在上眼睑增加了一个瘢痕性成分，严重影响了该眼睑的动态。通过同时行上眼睑延长和面部重建，成功地处理了患者的角膜状况。
为了避免角膜穿孔，对于 5/9 号裂隙，必须同时进行上下眼睑重建。应持续随访受累患者，以预防弱视。
