Colgajos o injertos cutáneos para la corrección de defectos palpebrales de gran tamaño / Flaps or cutaneous grafts for the correction of large eyelid defects

Objetivo: Describir los resultados estéticos y funcionales con el uso de colgajos o injertos cutáneos en la corrección de defectos palpebrales de gran tamaño. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, de 15 pacientes con lesiones tumorales o cicatrizales que provocaron defectos palpebrales de gran tamaño, desde enero a diciembre del año 2016, en la Consulta de Oculoplastia del Instituto Cubano de Oftalmología Ramón Pando Ferrer. Resultados: El 73,3 por ciento de los pacientes fue del sexo masculino y mayores de 60 años. Las lesiones tumorales representaron el 73,3 por ciento y el carcinoma basal el 53,3 por ciento. El párpado inferior fue el más comprometido. En el 60 por ciento de los casos se realizó colgajo cutáneo; de ellos, a 8 pacientes (88,8 por ciento) de tipo Tenzel. En el 73,3 por ciento de los pacientes no se presentaron complicaciones. El hematoma posquirúrgico fue la complicación general más frecuente (25 por ciento). Conclusiones: Los defectos palpebrales de gran tamaño se presentan en mayor cantidad en los pacientes mayores de 60 años, del sexo masculino. Predomina el carcinoma basal en el párpado inferior. La técnica reconstructiva con colgajos e injertos cutáneos resulta efectiva en la mayoría de los casos y se reporta un mínimo de complicaciones(AU)

Objective: To describe the esthetic and functional results of the use of flaps or cutaneous grafts for the correction of large eyelid defects. Method: A prospective, descriptive and observational study of 15 patients with tumoral or scar lesions that caused large eyelid defects was conducted from January to December, 2016 in the Oculoplasty Service of Ramon Pando Ferrer Cuban Institute of Ophthalmology. Results: In the study, 73.3 percent of patients were males aged over 60 years. Tumoral lesions were present in 73.3 percent of patients whereas basal carcinoma was found in 53.3 percent. The lower eyelid was the most affected. Sixty percent of cases were corrected with cutaneous flap, eight of them (88.8 percent) with Tenzel-type flap. No complications were seen in 73.3 percent of patients. Postsurgical hematoma was the most common complication (25 percent). Conclusions: Large eyelid defects were observed in a higher number of male patients aged 60 years. Basal carcinoma in the lower eyelid predominated. The reconstructive technique using flaps or cutaneous grafts proved to be effective in most of the cases, with minimal complications(AU)

Carcinoma de glándulas sebáceas del párpado / Sebaceous gland carcinoma of the eyelid

Los principales tumores malignos que afectan los párpados en orden de frecuencia son el carcinoma basocelular, el carcinoma de glándulas sebáceas, el carcinoma de células escamosas y el melanoma maligno. El carcinoma de glándulas sebáceas es una neoplasia originada en las glándulas sebáceas con predilección por cabeza y cuello, especialmente por las glándulas de Meibomio, aunque también puede afectar a las glándulas de Zeiss o ambas y su sitio de mayor presentación es en el párpado superior. Se presenta un paciente masculino de 46 años de edad quien presenta lesión pediculada y vascularizada en párpado inferior izquierdo posterior al drenaje de un supuesto chalazión. Se realiza rasurado de la lesión y recidiva por segunda ocasión. El carcinoma de células sebáceas se maneja con resección amplia y reconstrucción con técnica de Hughes(AU)

The main malignant tumors affecting the eyelids in an order of frequency are basal cell carcinoma, sebaceous gland carcinoma, squamous cell carcinoma and malignant melanoma. Sebaceous gland carcinoma is a neoplasm originating in sebaceous glands predominantly from the head and neck, particularly meibomian glands, though it may also affect the glands of Zeis or both, and its most common site of presentation is the upper eyelid. A 46-year-old male patient presents with a pediculated vascularized lesion on his lower left eyelid after drainage of a supposed chalazion. The lesion was shaved off and reoccurred a second time. Sebaceous cell carcinoma is managed with broad resection and reconstruction by Hughes' technique(AU)

Frequência de ocorrência das afecções dos anexos oculares e do olho externo / Frequency of occurrence of affections of the adnexa and external eye

RESUMO Objetivo: Observar a frequência de ocorrência das afecções que acometem os anexos oculares e o olho externo, assim como descrever o perfil demográfico dos portadores, na região centro oeste do estado de São Paulo. Métodos: Estudo prospectivo, populacional e aleatorizado, no qual foram avaliadas 11.000 pessoas da região centro-oeste do Estado de São Paulo, nos anos de 2004/2005, por meio de consultas oftalmológicas e utilizando uma unidade móvel. Foi realizado exame oftalmológico completo. Os dados foram transferidos para tabela Excel, utilizando-se para o presente estudo dados referentes aos anexos e doenças do olho externo. A frequência de ocorrência dos problemas detectados foi analisada estatisticamente. Resultados: Foram detectadas 1.581 (14,6%) afecções de anexos ou do olho externo, sendo as mais frequentes o pterígio (9,4%), o hordéolo (0,8%) e as alterações do posicionamento palpebral (1,7%) (ectrópio, ptose e triquíase). Trauma, ectrópio e pterígio foram estatisticamente mais frequentes na população masculina. Conclusão: Das afecções pesquisadas, a de maior ocorrência na população foi o pterígio, seguido das alterações inflamatórias e do posicionamento palpebral.

ABSTRACT Purpose: To observe the frequency of occurrence of affections involving the adnexa or the external eye, as well as to describe the demographic profile of patients. Methods: A prospective, population based, randomized study was done in the Midwest region of the state of São Paulo, in the years 2004/2005. Using a Mobile Ophthalmic Unit we evaluated 11,000 people. A comprehensive eye exam was performed. Data were transferred to excel table and for this study we used information relating to annexes and external eye diseases. The frequency of occurrence of the problems detected was statistically analyzed. Results: We identified 1,581(14.4%) disorders in the adnexa or in the external eye. The most common disorders were pterygium (9.4%), hordeolum (0.8%) and changes in eyelid position (1.7%) (ectropion, ptosis and trichiasis). Trauma, ectropion and pterygium were statistically more frequent in the male population. Conclusion: Of the surveyed disorders the most frequent in the population was pterygium, followed by inflammatory changes and alterations in the eyelid position.

Alterações palpebrais: frequência de ocorrência e perfil dos portadores em amostra populacional brasileira / Eyelid disorders: frequency of occurrence and profile of carriers in a Brazilian population sample

Objetivo: Apresentar a frequência de ocorrência das alterações palpebrais em uma amostra populacional brasileira, assim como as características de seus portadores. Métodos: Estudo transversal utilizando amostra populacional aleatorizada, realizado nos anos de 2004/2005, em nove cidades da região centro-oeste do estado de São Paulo. Foram examinadas 7654 pessoas sendo os participantes avaliados segundo variáveis demográficas e exame oftalmológico completo. As alterações palpebrais foram avaliadas por meio de exame externo usando lanterna e lâmpada de fenda. Os dados obtidos foram analisados estatisticamente. Resultados: As alterações palpebrais como a triquíase e o ectrópio foram mais relacionadas às características homens, brancos, queixa de redução de acuidade visual para perto. Foi realizado tratamento cirúrgico em 72,7% das triquíases detectadas, assim como 28,5% dos ectrópios. Já os casos de ptose palpebral foram relacionados ao sexo feminino, brancas, com queixa de diminuição da acuidade visual para perto e 26,3% necessitaram de cirurgia. Entrópio foi detectado em um caso, masculino, branco e epibléfaro foi observado em um indivíduo do sexo feminino, parda. Conclusão: A alteração palpebral mais presente na população geral brasileira é a triquíase, seguida da ptose palpebral e do ectrópio. Os autores chamam a atenção para o fato de os portadores não possuírem queixas relacionadas às alterações palpebrais.

Purpose: to show the frequency of occurrence of the eyelid disorders in a Brazilian population sample, as well as the characteristics of the carriers. Methods: a transversal study using a random population sample was carried out in the years 2004/2005, involving nine cities of the middle west region of the State of São Paulo - Brazil. We had 7654 participants which were evaluated according to demographic variables and complete ophthalmological examination. The eyelid disorders were detected using a lantern and slit lamp. Data were statistically analyzed. Results: eyelid disorders such as of trichiasis and ectropion were more related to the characteristics men, whites, complaining of reduced near visual acuity and 72.7% of trichiasis underwent surgical treatment, as well as 28.5% of patients with ectropion. Ptosis was related to the females, whites, complaining of reduced near visual acuity and 26.3% required surgery. Entropion was detected only in one case, male, white and a case of epiblepharon was observed in a female, brown. Conclusion: the most frequent palpebral disorder observed in the Brazilian general population is trichiasis, followed by ptosis and ectropion. The authors call attention to the fact that carriers do not have complaints related to the eyelid disorders.

Ultrasonographic Measurement of Upper Eyelid Thickness in Korean Children with Epicanthus

PURPOSE: Upper eyelid thickness was measured to determine whether there is a difference in the thickness of the upper eyelids in children with and without epicanthus. METHODS: Children were enrolled into the epicanthus group or non-epicanthus (control) group. The children with epicanthus were classified into four subgroups according to the Duke-Elder's classification. The thickness of the upper eyelid was measured at five points with A-scan ultrasonography. RESULTS: There was no significant difference in upper eyelid thickness between the epicanthus group and control group (P>0.05) or between the subgroups of the epicanthus group (P>0.05). CONCLUSIONS: This result suggests that the etiology of epicanthus may not be hypertrophy of soft tissue.

Aspectos epidemiológicos das lesões pseudoneoplásicas e benignas da pálpebra na região de Botucatu - São Paulo / Eyelid pseudoneoplasic and benign lesions at Botucatu region - epidemiological aspects

Objetivo: Conhecer as características das lesões palpebrais pseudoneoplásicas e benignas em nossa região. Local: Faculdade de Medicina de Botucatu - São Paulo. Método: Estudou-se a ocorrência das lesões palpebrais pseudoneplásicas, benignas da pele e dos anexos, na Faculdade de Medicina de Botucatu - UNESP, no período de 1989 a 1999, avaliando-se a idade, o sexo, a faixa etária, a localização da lesão e os diagnósticos clínico e histopatológico. Resultados: No período estudado, foram removidas e tiveram confirmação diagnóstica, através de exame histopatológico, 311 lesões: 169 (54,34 por cento) lesões pseudoneoplásicas, 114 (36,66 por cento) lesões benignas da pele e 28 (9,00 por cento) lesões benignas derivadas de anexos cutâneos. A maioria dos pacientes apresentava mais de 40 anos (66,88 por cento) e o sexo feminino foi o mais acometido (65,27 por cento). As lesões pseudoneoplásicas e as benignas predominaram na pálpebra superior, enquanto as lesões anexiais não apresentaram localização preferencial. Conclusão: Encontramos 54,34 por cento de lesões pseudoneoplásicas, 36,66 por cento de lesões benignas da pele e 9,00 por cento de lesões benignas derivadas de anexos cutâneos. As mulheres foram as mais acometidas e a localização mais freqüente foi a pálpebra superior. O exame anatomo-patológico foi importante para a determinação do diagnóstico correto e deve ser realizado mesmo que a suspeita seja de lesão benigna.

The prevalence of disabling ocular complications of leprosy: a global study.

A world-wide study on the ocular complications of leprosy has been carried out over the past ten years. The data from 4772 patients, designed to give baseline information for a five-year incidence study, have been analysed. Blindness due to leprosy was seen in 3.2% of the sample and 7.1% had Grade 2 visual disability. The causes of visual impairment in the disease are discussed and it is emphasized that a high proportion of these are preventable, particularly through the early use of multidrug therapy. The active participation of ophthalmologists in the management of the disease is still required since many of the blinding complications respond well to surgery.

Tumours of eyelid: a clinicopathologic study.

A retrospective study of 207 cases of eyelid tumours and tumour like lesions, diagnosed histopathologically, was carried out for the period 1957 to 1991. There was a slight preponderance of males as the male/female ratio was 1.3:1. The age of the cases ranged from one to 80 years. Benign tumours were usually seen in the first two decades whereas the malignant tumours were common in the age group of 40 to 60 years. Malignancy was noticed in 85 cases (41.1%). Of these cases of malignant tumours, basal cell carcinoma was the commonest (38.8%) followed by sebaceous carcinoma (27.1%), squamous cell carcinoma (22.4%), basisquamous cell carcinoma (8.2%) and melanoma (3.5%). The ratio of basal cell carcinoma to squamous cell carcinoma was 1.74: 1. Of the 122 benign lesions common ones were vascular tumours (21.3%), neural tumours (18.0%), dermoid cysts (16.4%), squamous cell papilloma (13.1%) and naevi (12.3%).

Lesöes benignas e pseudo neoplasicas da palpebra na Faculdade de Medicina de Botucatu / Lid benign and pseudoneoplastic lesions in Botucatu Medical School

Estudou-se a ocorrência de lesöes pseudoneoplásicas e lesöes benignas da pele e anexos palpebrais na Faculdade de Medicina de Botucatu de 1978 a 1988. Encontrou-se 128 casos que tiveram confirmaçäo diagnóstica através de exame histopatológico: 81 (63,28//) lesöes pseudoneoplásicas, 31 (24,21//) lesöes benignas da pele e 16 (12,50//) lesöes benignas de anexos cutâneos. Nos 3 grupos de lesöes o sexo feminino foi o mais acometido. Lesöes pseudoneoplásicas e benignas da pele ocorreram mais na pálpebra superior e lesöes anexiais, näo tiveram localizaçäo preferencial. Os autores chamam a atençäo para a importância de submeter o material excisado a exame histopatológico, pois o diagnóstico clínico foi incorreto em muitos casos

A study of ocular complications in leprosy.

A total of 380 leprosy patients were studied in four different leprosy hospitals. The involvement of eye was found in 18.95% of cases in which 10.97% in lepromatous leprosy and 8.16% in non-lepromatous leprosy cases. In total cases studied 52.63% were of lepromatous leprosy and 47.37% of non lepromatous leprosy cases. Among them 11.05% were males and 18.95% were females. In 72 cases of ocular involvement, males constituted 80.56% and females 19.44% of cases. Maximum cases (52.78%) of ocular involvement were in leprosy patient with 5 to 10 years of duration. Blindness among the total leprosy patients studied was 1.84% which was mainly due to corneal opacity following exposure keratitis and ulceration, iridocyclitis and its complications.

A clinical study of eye complications in leprosy.

A study was conducted to find out the incidence of ocular complications in leprosy. The ocular lesions were found in 6.6% of lepromatous leprosy and 1.6% in nonlepromatous leprosy. Out of 150 patients with eye lesions 74% were males and 80% belonged to lepromatous leprosy. The age group in all the patients varied from 3rd to 6th decade. Mean duration of leprosy ln lepromatous leprosy was 6.2 years. The important eye complication observed were lagophthalmos (8.1%), corneal ulcers (10%) and iridocyclitis (24%). The loss of eye-brows (76%) was found to be most frequent in this study followed by corneal lesion (62%). It is concluded that examination of eyes are essential in all types of leprosy.