ABSTRACT
Basal cell carcinomas (BCC) make up about 90% of malignant tumors of the eyelids. Although they are generally slow-growing tumors, in the periocular region can cause significant morbidity due to orbital invasion. In the present study we followed the associations between the various types of BCC with the depth of invasion, respectively the Breslow stage (BS) and with the pT category. The study included a number of 92 cases of eyelid BCC from the Plastic Surgery and Ophthalmology Departments of the Craiova County Emergency Clinical Hospital which were processed and diagnosed in the Pathological Laboratory of the same hospital. Histopathological analysis of the 92 BCCs indicated that in 72 cases the tumors were composed of a single growth pattern, and in 20 cases they were composite, associating two or more growth patterns. The cases with a single growth pattern corresponded in 53 cases of nodular BCC, in 9 cases of infiltrative BCC, in 2 cases of superficial BCC and in 8 cases of micronodular BCC. The composite types corresponded in 10 cases to the association of the nodular type with the micronodular one, in 8 cases to the association of the nodular type with the infiltrative one and in 2 cases to the association of the infiltrative type with the micronodular one. Statistical analysis indicated significant associations between BS, pTa and the histopathological type of tumors, the mixed types being frequently present in cases with high SB and advanced pT.
ABSTRACT
Purpose. To report a case of malignant glaucoma in a pseudophakic female patient, with no history of glaucoma, resolved through pars plana anterior vitrectomy. Case presentation. An 80-year-old female patient presented in our Emergency Department after a five-day history of pain in her left eye (LE). In the last day, the patient noticed marked visual loss and ocular pain. Visual acuity was light perception and Goldman tonometry was 80 mmHg in her LE. The biomicroscopy revealed absent peripheral and central anterior chamber (AC) and posterior chamber (PC) pseudophakia. Posterior segment ecography showed no vitreous or choroidal abnormalities. A peripheral laser YAG iridotomy was made and the patient was treated with intravenous 20% mannitol, topical timolol, topical brimonidine, and topical cycloplegics. 12 hours later, despite a patent iridotomy in the LE eye, intraocular pressure (IOP) was 55 mmHg, absent AC with severe corneal edema. The diagnosis of pseudophakic malignant glaucoma was made and laser YAG capsulotomy was performed with no resolution of symptoms and signs. 24 hours later, we performed pars plana anterior vitrectomy. Postoperatively, the AC depth increased and the IOP decreased to 20mmHg. After a week, the patient was discharged with hand movement perception visual acuity in her LE, 20 mmHg IOP, reduced corneal edema, normal depth AC. After a month, the corneal edema resolved, the visual acuity was 2/50, IOP was 20mmHg, and the AC had a normal depth. Conclusion. Malignant glaucoma is a sight threatening condition, reported in pseudophakic eyes. Although, literature describes cases solved by cycloplegics and laser YAG capsulotomy, our patient needed pars plana anterior vitrectomy for the resolution of symptoms and signs.
