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CASE REPORT
Year : 2022  |  Volume : 25  |  Issue : 2  |  Page : 203-204

Simple surgical approach for treatment of ankyloblepharon filiforme adnatum: A case report


Department of Ophthalmology, Liv Hospital Ankara, Turkey

Date of Submission15-Sep-2020
Date of Acceptance12-Oct-2021
Date of Web Publication16-Feb-2022

Correspondence Address:
Dr. N Akagun
Liv Hospital Ankara, Bestekar sok. No: 8 Cankaya/Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_571_20

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   Abstract 


Ankyloblepharon flliforme adnatum (AFA) is a rare congenital abnormality of the eyelids. Upper and lower eyelids are joined by single or multiple bands. It is usually isolated but can be associated with ophtalmic and systemic diseases. AFA is potentially amblyopic condition. Treatment is quick, safe, and minimizes the risk of amblyopia. We report a case of newborn with isolated AFA at birth, treated by surgical excision of the band tissue.

Keywords: Ankyloblepharon filiforme adnatum, congenital anomalies, eyelid bands


How to cite this article:
Akagun N. Simple surgical approach for treatment of ankyloblepharon filiforme adnatum: A case report. Niger J Clin Pract 2022;25:203-4

How to cite this URL:
Akagun N. Simple surgical approach for treatment of ankyloblepharon filiforme adnatum: A case report. Niger J Clin Pract [serial online] 2022 [cited 2022 Dec 2];25:203-4. Available from: https://www.njcponline.com/text.asp?2022/25/2/203/337763




   Case Presentation Top


A newborn male was referred for the assessment of his left eyelids. He was born at term, weighing 3200 g. Pregnancy and delivery were unremarkable. A detailed pediatric assessment was clear. Ocular examination showed a peripheral band leading to adhere the left upper and lower eyelids. The right eye was normal. The band of tissue was excised with Vannas scissors under sterile conditions. Subsequent left eye examination did not reveal any other abnormality. At his follow-up examinations, ocular findings were normal.


   Conclusion Top


Ankyloblepharon filiforme adnatum (AFA) is a potentially amblyogenic congenital abnormality of the eyelids. Treatment is quick, safe, and minimizes the risk of amblyopia.


   Introduction Top


AFA is a condition in which the eyelids show single or multiple bands joining the upper and lower eyelids.[1] The bands are 1–10 mm long and less than half a millimeter in width. They arise at the back of the origins of the eyelashes.[1] Von Hasner in 1982 first reported this condition.[2]

AFA is a benign, rare but potentially amblyopic congenital malformation.[2] During embryonic life, the eyelids stay fused until about the fifth month of intrauterine life. At this point, they begin to separate, but may remain partially attached until the seventh month.[2] This abnormality occurs when the lids fail to separate, either partial or complete, resulting in shortening of the palpebral fissure. These limit eyelid movement.

AFA may present as an isolated finding, may be associated with other congenital anomalies or it may be a part of a well-defined syndrome.[3] Therefore, it is important to look for systemic abnormalities.[3] Treatment of AFA is simple excision of tissue band from lid margins.


   Case Report Top


A 7-day-old male infant was referred for the assessment of his left eyelids to Liv Hospital Ophthalmology Department, Ankara, Turkey. He was born at term, weighing 3200 g.

The baby was born at 39 weeks' gestation by elective caesarean section to a 27-year-old second gravid female and 33-year-old healthy male, out of non-consanguineous marriage. The pregnancy was normal and uneventful; no history of fever, rashes, or drug intake. The previous one sibling, aged three years, male, was healthy. There was no family history of congenital anomalies. A detailed systemic pediatric assessment did not reveal any other congenital abnormality.

Ocular examination showed a peripheral band arising from gray lines leading to adhere the left upper and lower eyelids [Figure 1]. Right eye was normal. The band of tissue was excised with Vannas scissors under sterile conditions. The procedure was performed under topical anaesthesia using proparacaine hydrochloride 0.5%. There was no significant bleeding [Figure 2]. Ciprofloxacin hydrochloride ointment two times daily for one week was prescribed.
Figure 1: Peripheral band arising from gray lines to adhere the left upper and lower eyelids

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Figure 2: No significant bleeding

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Subsequent left eye examination did not reveal any other abnormality. At his follow-up examinations 1 and 6 months later, ocular findings were normal.

Informed consent form was obtained from family of the case.


   Discussion Top


AFA is a rare but potentially ambylogenic congenital abnormality of the eyelids, in which single or multiple bands of tissue adhering the upper and lower eyelids.[4] AFA is usually an isolated condition however sometimes it may be associated with ophtalmic and systemic diseases.[4] Ophthalmic association is iridogoniodysgenesis with juvenil glaucoma.[4] Systemic diseases include cleft lip and palate, hydrocephalus, meningomyelocoele, cardiac defects, imperforate anus, syndactyly.[4]

AFA has also been reported in association with Edward's Syndrome (trisomy 18), Hay-Wells syndrome, the popliteal pterygium syndrome, and CHANDS (curly hair-ankyloblepharon-nail dysplasia syndrome).[5] A rare variant of AFA associated with only skin hypopigmentation has been reported.[6]

Treatment of AFA is surgically excision of the bands under sterile conditions.[5] This report highlights the simplicity in treating the condition and the importance of early intervention to prevent the development of occlusion of amblyopia.


   Conclusion Top


AFA is a potentially amblyogenic congenital abnormality of the eyelids. Treatment is quick, safe, and prevents the risk of occlusion amblyopia.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Gupta S, Saxena H. Isolated ankyloblepharon filiforme adnatum in a newborn. Int J Ophthalmol Clin Res 2018;5:086. doi: 10.23937/2378-346X/1410086.  Back to cited text no. 1
    
2.
Sarowa S, Jain K, Agarwal R. A newborn with ankyloblepharon filiforme adnatum. J Clin Ophthalmol Res 2018;6:63-5.  Back to cited text no. 2
  [Full text]  
3.
Bordin G, Valerio E, Cutrone M. Ankyloblepharon filiforme adnatum in a newborn. AJP Rep 2015;5:e12-3.  Back to cited text no. 3
    
4.
Chakraborti C, Chaudhury KP, Das J, Biswas A. Ankyloblepharon filiforme adnatum: Report of two cases. Middle East Afr J Ophthalmol 2014;21:200-2.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Williams MA, White ST, McGinnity G. Ankyloblepharon filiforme adnatum. Arch Dis Child 2007;92:73-4.  Back to cited text no. 5
    
6.
Kuruvilla SE, Simha AR. A rare variant of ankyloblepharon filiforme adnatum associated with skin hypopigmentation: A case report from South India. Indian J Ophthalmol 2016;64:241-3.  Back to cited text no. 6
[PUBMED]  [Full text]  


    Figures

  [Figure 1], [Figure 2]



 

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