Surgical excision of periocular basal cell carcinomas.

The purpose of this study was to determine the histological clearance and clinical recurrence rates following excision of primary periocular biopsy-proven basal cell carcinomas (BCCs) in a teaching hospital in United Kingdom and compare it with other published reports. Records of consecutive patients with a biopsy proven diagnosis of primary periocular BCCs treated surgically at our hospital between 1995 and March 2003 were reviewed. Twenty seven cases (25 patients) were identified. Intra-operative frozen sections (IFS) were performed in 17 (63%) of the cases with clear margins on IFS in 16/17 (94%) of these cases. Histology revealed complete excision in 25/27 (92.5%) of cases. The results of excision of periocular BCCs in our setting particularly with IFS are comparable with other published reports. A reaudit is recommended in 5 years to allow a larger patient population with greater follow up, which would enable us to give more definitive judgment on this treatment modality.

Comparative study of the subjective and objective grading of ptosis surgery outcomes.

AIMS: To assess the results of blepharoptosis surgery in our hospital by subjective and objective grading of the outcome and comparing them to determine their degree of corelation. METHODS: Retrospective interventional case series report supplemented by postal questionnaires and telephonic patient surveys. The study included 107 eyelids of 78 patients. Using a simple grading system, surgical outcome was objectively graded as good, suboptimal, or poor. Outcome was also defined according to the patients' perspective as good, suboptimal, or poor. Level of agreement between the subjective and objective grading of the outcome was measured using a weighted kappa analysis. RESULTS: The objective results were classed as good-68/107 (63.5%), suboptimal--18 eyelids (16.8%), and poor--21 eyelids (19.6%). The subjective results were obtainable in 91 eyelids and were good--54/91 (59.3%), suboptimal--8/91 (8.7%), and poor--29/91 (32%). A mismatch between objective and subjective outcomes was seen in 16 eyelids. We saw a statistically significant corelation between the objective grading and the patients' perspective (P<0.001). CONCLUSION: Our overall ptosis surgery results are comparable with rates previously reported. The subjective and objective outcomes of ptosis surgery may sometimes vary, but nevertheless exhibit substantive agreement when measured by this simple grading system.