Dellen corneal secundario a carcinoma epidermoide de conjuntiva / Corneal dellen secondary to epidermoid carcinoma of the conjunctiva

El dellen corneal es un área de adelgazamiento corneal localizado como consecuencia de la deshidratación provocada por la falta de humectación relacionada con una zona adyacente de abultamiento conjuntival. Se presenta una paciente femenina de 72 años, blanca, con antecedentes de hipertensión arterial, quien refirió lagrimeo y sensación de cuerpo extraño en el ojo izquierdo, de una semana de evolución. Al examen biomicroscópico se observó tejido fibrovascular en conjuntiva bulbar nasal que infiltraba la córnea, sobreelevado, de superficie lisa, no queratinizada, acompañada de inyección conjuntival y múltiples neovasos. En la córnea periférica y adyacente a esta se observó depresión de base limpia, redondeada, de 6 mm de extensión y profundidad hasta estroma anterior. Teniendo en cuenta las características de la lesión, se planteó como diagnóstico presuntivo dellen corneal secundario a pterigium grado II sintomático. La biopsia informó carcinoma de células escamosas, moderadamente diferenciado, asociado con un extenso infiltrado inflamatorio a predominio de linfocitos(AU)

Corneal dellen is an area of localized corneal thinning as a result of dehydration caused by lack of humectation associated to an adjoining conjunctival bulging. Here is a 72-years old Caucasian woman with a history of hypertension, who presented continuous tearing and feeling of a foreign body in her left eye during a week. The biomicroscopic exam showed fibrovascular tissue in nasal bulb conjunctiva, which infiltrated into the cornea, it was raised of flat surface, unkeratinized, accompanied with conjunctival injection and multiple neovessels. In the peripheral cornea and adjacent to it, there was a clean, rounded depression measuring 6 mm of extension and depth up to the anterior stroma. The presumptive diagnosis was corneal dellen secondary to symptomatic grade II pterygium. The biopsy yielded the presence of squamous cell carcinoma, moderately differentiated, and associated with extensive inflammatory infiltrate with predominance of lymphocytes(AU)

Dellen Following Blepharoplasty: Report of 14 Cases

We report 14 cases of dellen in 2000 blepharoplasties. The purpose of this article is to report rare complication of corneal dellen that developed after blepharoplasties. We observed 6 cases (0.5%) of dellen among 1200 patients who underwent upper blepharoplasty, and 8 cases (1%) among 800 lower blepharoplasty cases. Most patients who developed dellen were in their forties and fifties. All dellen were observed at temporal limbus, and accompanied conjunctival bleb. Most of the dellen developed in dry season (from November to March) and were frequently found in the middle-aged neurotic women who lived in apartments where room temperature is relatively high. Patching to the eyes, artificial tear and steroid eye ointment were applied to the dellen patients, who usually healed without corneal opacity within 2 weeks. In conclusion, we think that the cause of the conjunctival bleb and dellen are obstruction of small lymphatic vessels due to too meticulous hemostasis and too tight key suture in case of lower blepharoplasty.

Painful,Large Bleb after Glaucoma Filtering Surgery

An overhanging, large bleb after filtering surgery leads to various complications ranging from foreign-body sensation to endophthalmitis. Herein we report two case of large painful blebs in nasal area. Argon laser was initially used for its shrinkage. However, this procedure was not successful, requiring surgical excision of bleb. The tissue was then examined to evaluate the cause of failure with the argon laser treatment. On examination, the bleb showed a pseudocyst, and hyaline degeneration in the inner membrane of the bleb. Shrinkage of the large bleb resulted in resolution of the pain.