Background. Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Aim. To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Methods. This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2–3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis. Results. Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection. Conclusion. Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC.
Purpose This study aimed to determine the frequency, sociodemographic profile, clinical presentation, patterns of injury, treatment and outcomes of cases of simultaneous bilateral ocular trauma. Methods This retrospective study was conducted from May 2015 to April 2019. The medical records of patients presenting with bilateral ocular injuries were reviewed. Results Among the 402 patients presenting with ocular injuries, 34 (8.46%) had simultaneous bilateral ocular trauma. The majority were male (70.59%) and the mean age was 26.82 ± 15.86 years (range: 2–70 years).Most injuries occurred away from home (64.71%), mainly in roads (32.36%) or playgrounds (14.71%), and the vast majority (91.18%) were non-occupational in nature. Mechanical injuries were most frequent (47.05%), followed by cracker (17.65%), chemical (17.65%) and thermal (11.76%) injuries. Most cases occurred due to assault (26.47%), road traffic injury(20.59%) or sports/recreational activities (17.65%). The majority of victims were not using protective devices at the time of injury (82.35%) and had associated polytrauma (58.82%).Closed and open globe injuries accounted for 29.41% and 14.71% of cases, respectively, mostly involving zones I (55.00%) and II (40.00%). Orbital fractures occurred in 27.94% of eyes. Category I and II ocular trauma scores were noted in 5.88% and 7.35% of eyes, respectively. Overall, 13.24% were blinded as a result of the trauma. Conclusion Simultaneous bilateral ocular trauma is rare and occurs mostly following traffic accidents, assault or recreational activities. In particular, younger males are more prone to bilateral ocular injuries, the majority of which are severe and associated with poor outcomes.
To assess the outcome of lateral tarsal strip (LTS) for the involutional entropion and ectropion. Materials and Methods: A quasi study was carried out in a tertiary eye hospital of Dhaka, Bangladesh, between January 2013 and December 2020. This study included all patients who underwent lateral tarsal strip (LTS) procedure for the correction of involutional entropion and ectropion. Group A patients were presented with involutional entropion and group B patients were presented with involutional ectropion. We assessed surgical outcome and postoperative complications. Results: Out of 48 lower eyelids marginal malposition of 43 patients were studied in this study and 5 cases were presented bilateral lower lid marginal malposition. Lateral tarsal strip (LTS) procedure was a unique procedure to correct the involutional entropion (24 eyelids 50%), involutional ectropion (24 eyelids 50%), involving the lower eyelid. The male to female ratio was almost 2.6:1. The mean age was 68.49 years with 54 years to 90 years age range. The surgical correction was satisfactory in 95.9%, and 91.7% of lower eyelids involutional entropion, and involutional ectropion respectively. Conclusions: Lateral tarsal strip (LTS) is a unique procedure to achieve better cosmetic and functional outcome for the correction involutional eyelid marginal malposition (entropion, and ectropion).
Purpose: To assess the surgical outcome of Blepharophimosis syndrome (BPES). Materials and Methods: This interventional study has been evaluated pre and postoperatively of fifty patients in two tertiary eye hospital in Bangladesh. All patients were divided into two groups like as group-A (35 patients) and group-B (15 patients). Telecanthus, Epicanthus and ptosis were corrected 3 months apart in group-A. All procedures were done in single setting in group-B. Results: Male patients were 21 (42%) and female patients were 29 (58%). In group-A, Satisfactory outcome of Y-V plasty was 89%, and 11% patient presented unsatisfactory correction of telecanthus. Under correction after ptosis surgery was observed in 02 patients. In group-B, satisfactory outcome of C-V plasty was 93% and under correction was observed in 4 patients followed by ptosis surgery. Conclusion: There is no significant difference between Y-V plasty and C-V plasty to correct telecanthus and epicanthus. Ptosis correction resulted well in separate sittings.
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