Ophthalmic considerations in the management of Tessier cleft 5/9.
OBJECTIVE
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.


METHODS
Interventional case report and literature review.


RESULTS
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.


CONCLUSIONS
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.
Pereira
Filipe J
FJ
Craniofacial Unit, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Milbratz
Gherusa H
GH
Cruz
Antonio A V
AA
Vasconcelos
João J A
JJ
D000015:Abnormalities, Multiple / Q000601:surgery*; D019465:Craniofacial Abnormalities / Q000601:surgery*; D005124:Eye Abnormalities / Q000601:surgery*; D005143:Eyelids / Q000002:abnormalities; D005145:Face / Q000002:abnormalities; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000002:abnormalities; D019651:Plastic Surgery Procedures