PurposeTo evaluate the anterior segment biometry characteristics in congenital cataract patients before undergoing surgery in a tertiary eye care centre.MethodsWe retrospectively reviewed the charts of congenital cataract patients aged less than 15 years who had undergone the congenital cataract surgery from Jan-Dec, 2015. 451 eyes of 351 patients were reviewed. The eyes were examined using an autorefract-keratometer, applanation A-scan and parameters like keratometry, axial length, corneal astigmatism were noted.ResultsThe mean age at the surgery was 92.4 ± 4.13 months (range 6 months to 15 years). The ratio of boys to girls was 2.34:1. The mean axial length was 21.94 ± 1.94 mm. Girls had shorter axial length than boys (21.53 mm vs 22.11 mm, p = 0.01). The axial length in the cataractous eyes in bilateral cases was significantly smaller than that in the unilateral cases (21.46 mm vs 22.55 mm, p < 0.0001).The mean keratometry was 44.12 ± 2.6 D. Girls had larger mean keratometry value than boys (44.71 vs 43.88, p = 0.0032). Keratometry values were higher in cataractous eyes in bilateral cases than in the unilateral cases (44.61 D vs 43.51 D, p < 0.0001). The mean corneal astigmatism was 1.49 ± 1.13 D. The prevalence of the corneal astigmatism of 2.0 D or more was 25.5%. The with-the-rule astigmatism was the most frequent type (62.53%). Girls had higher mean astigmatism than boys (p = 0.0122). The mean corneal astigmatism was higher in the cataractous eyes in bilateral cases than in the unilateral cases (p = 0.0094).ConclusionsThe axial length, mean keratometry and corneal astigmatism in congenital cataract patients varied with age, gender, and laterality. The data on biometry characteristics of Nepalese pediatric patients provided in the present study are of clinical significance and hence greatly enhance the guidelines for treatment decisions, IOL power calculations and management of congenital cataract patients.
Introduction: Eye lid and adnexal tumours are one of the major problems we see in the oculoplastic department. Malignant eye lid tumours are rare in comparison to benign and diversity in its clinical presentation makes it difficult to diagnose earlier. Eyelid malignancies can mimic a host of benign neoplasms and other less aggressive neoplastic or non-neoplastic inflammatory conditions and need differentiation before definitive therapy is planned. Out of 90% of all skin cancer occurring in head and neck region 10% occurs in the eyelid. A histopathological study confirms the diagnosis that can be correlated with patient history and other clinical data.
Objectives: To study the clinicopathological correlation and its outcome in patients with malignant eyelid and adnexal tumours presenting at Biratnagar eye hospital.
Methodology: Details of the cases of histopathologically proven malignant eyelid and adnexal tumours presenting to the department of oculoplasty from July 2016 to August 2019 were recorded. The duration of disease, presenting symptoms, risk factors, demographic data, clinicopathological correlation with its accuracy and mode of treatment were analyzed using SPSS 17.
Results: Out of total 28 patients, male were 53.6% and female were 46.4%. The mean age of presentation was 60.5±11.8 years. 53.6% tumors were located in upper lid, 39.9% were located in lower lid and 7.1 % were located in medial canthus. Basal cell carcinoma and sebaceous gland carcinoma were the most common type of malignancies (35.7% each) followed by 28.6% of squamous cell carcinoma of eyelid. The clinicopathological correlation revealed 75% of clinical accuracy. Different types of reconstructions were done according to the size and site of the defect. Modified Hughes procedure for lower eyelid defect was the most common procedure performed (32.1%), followed by 14.3% Cutler beard, 28.6% Cutler beard with post auricular cartilage graft, 10.7% Glabellar flap rotation 7.1% had combined procedure and 4.3% direct closure .
Conclusion: Sebaceous cell carcinoma and Basal cell carcinoma were the most common malignant tumors followed by squamous cell carcinoma. The upper lid was the most common site for such malignancy. Histopathological examination was useful for the establishment of complete and accurate diagnosis, which led to further management and follow up protocol for malignant eyelid tumours.
In this study, we present 2 patients, including 1 pediatric patient, with orbital tumors in the deep superonasal intraconal space, which were approached with upper fornix technique combined with a superior lateral cantholysis. The first patient was a 1-year-old girl who had presented with left upper eyelid retraction since the age of 2 months. Imaging studies revealed an orbital mass in the left postero-superonasal intraconal space. The second patient was a 71-year-old man who complained of decreased vision after cataract surgery in the left eye. Imaging studies revealed an orbital mass in the left superonasal intraconal space surrounding the optic nerve in the posterior orbit. In both the patients, incisional biopsy of the orbital mass with upper fornix approach was performed under general anesthesia. The diagnoses of congenital upper eyelid retraction caused by fibrosis in patient #1 and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in patient #2 were made, after pathological examinations. No significant intra- or postoperative complications occurred during a follow-up period of 10 months and 2 months, respectively.
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