Saturday, November 27, 2010

How I Removed a Benign Lesion Without Losing the Eyelashes

After seeing those two patients who were bitter about lossing their eyelashes after removal of eyelid lesions, I was referred a patient with a left upper eyelid mass which was thought to be a sebaceous cell carcioma. However, there was no evidence of involvement of the tarsal plate and the eyelashes were all present making it unlikely to be a sebaceous cell carinoma. Bearing in mind the two patients who were as upset over the lost eyelashes as the initial eyelid problem they had, I decided to plan my operation carefully.

A conspicuous mass in the left uppe eyelid.

No involvment of the tarsal plate.

The eyelashes are present.

One certain way of not creating an area of eyelashes loss is to perform a pentagon excision as in my previous blog. However, the procedure would mean the patient needs to wait at least a month before the eyelid will return to its normal shape. So I decided to perform a limited partial thickness excision of the mass sparing those at the lid margin. The lesion was sent for histology and the defect was closed with double sliding flap or the so-called H-flap.

Partial thickness excision of the eyelid mass.

The lid margin was spared.

Two sliding flaps were created to close the defect.

The flaps were bought together to see if they can be joined
without causing eyelid distortion.

At the completion of the surgery.

Post-operatively, the patient was pleased with the result as the eyelashes were not lost and there was no notching of the eyelid.

Apperance of the eye at 10 days.

The eyelashe were of uneven heights, as some them were cut
accidentally during the operation.

10 days after the operation.
Close-up view of the eye at 10-day post operation.

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