Ectrodactyly-Ectodermal Dysplasia-Cleft Syndrome: Ocular Findings and Surgical Treatment

Cornea. 2023 Sep 1;42(9):1172-1175. doi: 10.1097/ICO.0000000000003295. Epub 2023 Jun 21.

Abstract

Purpose: Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is a rare genetic disorder. We present ocular findings and their treatment in patients with EEC.

Methods and results: We report on 3 female patients (aged 59, 45, and 11 years) suffering from EEC with varying extraocular and ocular severity of phenotypic expression of the disease. Slit-lamp biomicroscopy, visual acuity, and medical treatment were evaluated over 4 months to 4 years. All patients experienced visual impairment and foreign body sensation. Examination revealed bilateral chronic blepharitis, dry eye syndrome, and corneal vascularization and clouding due to limbal stem cell deficiency (LSCD). Patient #1 presented a corneal ulcer with severe stromal thinning on the right eye. Allogeneic simple limbal epithelial transplantation (allo SLET), penetrating keratoplasty combined with allo SLET, and in total 5 amniotic membrane transplantation were performed to preserve the integrity of the eye. In patients #2 and #3, conservative therapy with lubricant eye drops, topical steroids, and antibiotics was sufficient to stabilize LSCD. In all cases, corneal epithelialization and improvement of visual acuity were achieved.

Conclusions and importance: To the best of our knowledge, this is the first report of surgical treatment in a patient with EEC. Allo SLET may be a surgical option to treat LSCD associated with EEC.

MeSH terms

  • Cleft Lip* / diagnosis
  • Cleft Palate* / complications
  • Cleft Palate* / diagnosis
  • Cleft Palate* / genetics
  • Corneal Diseases* / diagnosis
  • Corneal Diseases* / genetics
  • Corneal Diseases* / surgery
  • Ectodermal Dysplasia* / complications
  • Ectodermal Dysplasia* / diagnosis
  • Ectodermal Dysplasia* / surgery
  • Female
  • Humans
  • Limbal Stem Cell Deficiency*
  • Limbus Corneae*
  • Stem Cell Transplantation / methods

Supplementary concepts

  • Ectrodactyly
  • Ectrodactyly-cleft lip-palate syndrome