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Silicone lid closure technique effective for deep amblyopia

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SAN FRANCISCO — A surgical silicone suturing technique can be safe and effective in children with deep amblyopia and poor compliance to occlusion therapy, according to one surgeon here.

"Silicone lid closure can be used safely and effectively for treatment of amblyopia," Ossama Hakim, FRCS, said in a presentation at the American Association for Pediatric Ophthalmology and Strabismus meeting. "This technique affords a good option to restore vision in a formerly amblyopic eye and grants the child a lifetime of useful vision."

The surgery consists of passing one limb of double-armed 5-0 Prolene suture through the lid margin, the silicone sleeve and the other lid margin. The other limb is passed through the lid margin but behind the silicone sleeve to the other lid margin, creating a corneal-protecting Prolene mesh behind the silicone sleeve, Dr. Hakim said.

In a prospective study of 15 children, visual acuity improved from counting fingers preop to 20/40 to 20/200 postop in 12 children, while three children showed no improvement, Dr. Hakim said.

Complications included marginal lid irritation and erythema in six patients and suture break in two, he said.