Thanks to advances in design and perioperative care, the boston type i keratoprosthesis can now be considered a viable option for surgical visual rehabilitation in many patients with corneal pathology, and in certain groups the primary surgical procedure of choice.

Fig. 2 -External photograph of right (A) and left (B) eyes after treatment (after instillation of fluorescein). Both eyes showed significant resolution of stromal infiltrates, with the right eye demonstrating residual stromal thinning and a persistent epithelial defect temporally. The anterior chamber reaction improved significantly in both eyes

No abstract

We describe a rare case of an infant who was born with multiple congenital anomalies, including the absence of eyelids. This patient had many dysmorphic features consistent with a severe phenotype of ablepharon-macrostomia syndrome (AMS) including a fish-like appearance of the mouth, rudimentary ears, absence of body hair, thin skin, absent nipples, abdominal distension, and genital abnormalities. Upon presentation, there was severe exposure keratopathy causing large bilateral sterile ulcers culminating in corneal melting of both eyes. An amniotic membrane graft was used to attempt to maintain the corneal surface integrity. However, because of the late presentation, the corneas could not be salvaged. Extensive surgical reconstruction of both eyelids and bilateral penetrating keratoplasty was ultimately performed successfully to protect the ocular surfaces while trying to maximize the visual potential. Early amniotic membrane grafting may be done at the bedside and may help preserve the ocular in patients with severe eyelid deformities until more definitive treatment is performed.