Exérese tumoral seguida de blefaroplastia no tratamento de carcinoma de células escamosas em pálpebra inferior de equino / Tumoral resection followed by blepharoplasty in squamous cell carcinoma treatment in the lower eyelid of a horse

Background: Equines are routinely subjected to enucleation due to palpebral tumors. Blepharoplasties in horses, especially in the lower eyelid, are rarely performed due to the difficulty of sliding once the tissue around the eyes presents low mobility. Defects involving more than 50% of the lower eyelid is considered challenging after tumor removal. Squamous cell carcinoma (SCC) is the second most reported neoplasm in horses, being very common in regions of the lower eyelid, third eyelid, sclera and or cornea. The aim of this study is to present the Destro VY skin advancement flap as a blepharoplasty technique performed after surgical excision of a SCC, with total commitment of the lower eyelid, completely covering the right eye of a mare. Case: A 8-year-old mare Paint Horse, weighing 420 kg, was referred for evaluation of tumor tissue of 6.0 x 4.0 x 2.0 cm, with nodular and ulcerated appearance, involving the right lower eyelid, in its total extension and completely covering the eye, without adhering to it. Considering the initial suspicion of SCC, the treatment strategy performed was surgical eyelid excision and maintenance of the eye, followed by blepharoplasty as an attempt to reconstruct the eyelid. Under general inhalation anesthesia, the animal was placed in left lateral recumbency, when the surgical region was prepared and local anesthetic block was performed. After antisepsis, a skin incision was made circumscribing the tumor, respecting a margin of 10 mm apart and excision of all visible tumor tissue was performed followed by intralesional ozone therapy. Blepharoplasty was performed to cover the portions of the exposed lacrimal and zygomatic bones, as well as correction of the eyelid aesthetics. For this, Destro VY skin advancement flap was performed for reconstruction of the lower eyelid. An incision of approximately 7 cm in Vshaped skin was performed, and the subcutaneous tissue under the V was dissected, maintaining a central pedicle, responsible for the vascularization of the flap, which was slid, approximately 20 mm, towards the eye. After obtaining the desired skin approximation, Y-suture was performed, covering the exposed bone and reconstructing the lower eyelid. In the postoperative period, local instillation of mitomycin eye drops and systemic meloxicam administration were instituted. The mare had her vision restored, presenting satisfactory morpho functional and aesthetic results and no tumor recurrence during 1-year of follow-up. Discussion: The repair of lower eyelid imperfections is challenging, especially when they have large defects, and there are no reports of performing the Destro VY skin advancement flap technique in horses for lower eyelid reconstruction. In this case, the importance of the blepharoplasty technique is emphasized, avoiding enucleation, preserving horse's vision and aesthetics. In addition, aiming to avoid tumor recurrence, especially if surgical safety margins can not be achieved, other complementary treatments should be associated, including intralesional ozone therapy, mitomycin, an antineoplastic chemotherapy drug, and meloxicam, a COX-2 selective, non-steroidal anti-inflammatory drug, as performed in this study. It is concluded that the use of the Destro VY skin advancement flap technique for reconstruction of the external lamella in cases of SCC in the lower eyelid of horses is a feasible technique, which preserves the animal's vision, as well as aesthetics. The safety margin in the surgical excision of the SCC and the association of complementary therapies in the resolution of the condition are important points also to be considered.

Cirurgia corretiva para coloboma palpebral em um felino através da técnica de transposição da comissura labial / Corrective surgery for palpebral coloboma in a feline using the technique of transposition of the lip commissure

Background: Eyelid coloboma is considered a disease caused by failure in eye development during the first semester of pregnancy. In felines, its prevalence occurs in the upper eyelids, temporal region, and bilaterally. Coloboma, whether to a large or small extent, can lead to keratoconjunctivitis sicca and trichiasis, situations that can give rise to secondary ulcerative keratitis. The only corrective method is blepharoplasty. The current work aims to report the case of corrective surgery for eyelid coloboma in a feline with a successful postoperative period, in order to corroborate the effectiveness of the technique. We also report a finding of persistent pupillary membrane. Case: A 7-month-old male feline, no defined breed, was analyzed with a purulent mucus secretion and signs of discomfort in the right eye. After the ophthalmic screening, the presence of a coloboma was identified, which occupied approximately 50% of the size of the upper eyelid, in the temporal-dorsal region of the right eye. The cat had already undergone an enucleation of the left eye due to a perforation arising from ulcerative keratitis. Together with coloboma, the presence of blepharospasm, trichiasis, keratoconjunctivitis sicca, and secondary ulcerative keratitis were diagnosed. The presence of persistent pupillary membrane was also observed, a rare condition in the feline species. To confirm the ulcer, the fluorescein test was applied and treatment with antibiotic eye drops and lacrimomimetics (tear film replacements) drops was administered until the day of surgery, one week later. Concomitant with the institution of treatment prior to surgery, blood was collected for complementary pre-surgical tests such as blood count and biochemistry, which demonstrated satisfactory results. Corrective surgery was then instituted by the technique of transposing the labial commissure...

Description of clinical and surgical aspects of four cases of lip commissure to eyelid transposition for repair of eyelid coloboma in cats / Descrição clínico-cirúrgica de quatro casos de transposição da comissura labial para correção de coloboma palpebral em gatos

Background: Eyelid coloboma or eyelid agenesis is the most common congenital disease in cats. It can affect both the upper and the lower lids and is commonly bilateral. This congenital defect has been reported in several breeds, such as Persian and Domestic Short-Haired Cat. Generally, this defect results in inversion of the colobomatous eyelid, which can cause trichiasis and inflammatory keratitis and corneal ulceration. The only effective treatment is blepharoplasty. This paper describes the clinical and surgical aspects of four patients treated by lip commissure to eyelid transposition for the repair of eyelid coloboma using the technique described in 2010. Results of this procedure have never been reported in Brazil.Cases: Seven eyes of four cats presenting eyelid coloboma affecting up to two thirds of the eyelid were evaluated in this study. Two of the four cats were males and two were females; their average age was 3 years. All patients were admitted at the same institution, and the main issues were purulent discharge and impaired vision. Diagnosis was based on physical and ophthalmic examination. Non-ulcerative keratitis was present in all cases. Corneal ulcer was diagnosed in three patients by the fluorescein dye test. In two cats, a corneo-conjunctival dermoid was found at the temporal-dorsal region of one eye, and measured approximately 0.3 mm; and the other two [...]

Description of clinical and surgical aspects of four cases of lip commissure to eyelid transposition for repair of eyelid coloboma in cats / Descrição clínico-cirúrgica de quatro casos de transposição da comissura labial para correção de coloboma palpebral em gatos

Background: Eyelid coloboma or eyelid agenesis is the most common congenital disease in cats. It can affect both the upper and the lower lids and is commonly bilateral. This congenital defect has been reported in several breeds, such as Persian and Domestic Short-Haired Cat. Generally, this defect results in inversion of the colobomatous eyelid, which can cause trichiasis and inflammatory keratitis and corneal ulceration. The only effective treatment is blepharoplasty. This paper describes the clinical and surgical aspects of four patients treated by lip commissure to eyelid transposition for the repair of eyelid coloboma using the technique described in 2010. Results of this procedure have never been reported in Brazil.Cases: Seven eyes of four cats presenting eyelid coloboma affecting up to two thirds of the eyelid were evaluated in this study. Two of the four cats were males and two were females; their average age was 3 years. All patients were admitted at the same institution, and the main issues were purulent discharge and impaired vision. Diagnosis was based on physical and ophthalmic examination. Non-ulcerative keratitis was present in all cases. Corneal ulcer was diagnosed in three patients by the fluorescein dye test. In two cats, a corneo-conjunctival dermoid was found at the temporal-dorsal region of one eye, and measured approximately 0.3 mm; and the other two [...](AU)

Abraçadeira de náilon na correção de entrópico juvenil em cães shar-pei / Temporary correction of juvenile entropion in shar pei dogs with nylon band

O entrópio é a inversão de parte ou de toda margem palpebral, fazendo com que a pele com pelos atrite as superfícies conjuntival e corneal causando irritação. Em cães o entrópio pode ser hereditário ou adquirido, sendo que, algumas raças apresentam certa predisposição. Para propor um método mais eficiente com um material alternativo para a correção temporária do entrópio juvenil de cães da raça Shar Pei, foram utilizados 10 animais, com peso variável, com idades de até 12 meses, portadores de entrópio juvenil. Com os animais devidamente preparados e anestediados foram aplicadas as abraçadeiras de náilon em número e angulação referente ao grau de entrópio presente. Para a passagem da abraçadeira de náilon 2x80mm pelo subcutâneo palpebral foi usada agulha hipodérmica 40x16, na qual foi posicionada a abraçadeira em sua luz para que pudesse atravessar as duas porções de pele, formando então uma "prega". A aplicação das abraçadeiras demonstrou-se de fácil e rápida execução. As abraçadeiras permaneceram e foram efetivas nas pálpebras, garantindo a eversão das margens palpebrais, variando entre 5 e 12 semanas, com uma média de permanência de 8 semanas. Alguns animais tiveram que ser reoperados sucessivamente e foram acompanhados até a blefaroplastia definitiva. As complicações observadas são referentes ao prurido e ao desconforto inicial. A abraçadeira de náilon 2x8mm se constitui em material barato, de fácil esterilização, com aplicação rápida e efetiva nos casos de entrópio juvenil em cães da raça Shar Pei, mantendo a segurança e integridade dos bulbos oculares por 8 semanas em média.(AU)

The entropion is the reversing of part or all of eyelid margin, causing the skin with hair rubbing the surfaces conjunctival and corneal making irritation. Entropion can be inherited and some races of dogs have predisposition. To suggest a more efficient method, with an alternative material for the temporary eyelids fixation in juvenile Shar Pei dogs, 10 animals were anesthetized and prepared properly applied the ties of nylon band in number and angle related to the degree of entropion present. A 40x16 hypodermic needle was used for the passage of the 2x8mm nylon band by subcutaneous eyelid, which the band placed in its light so that it could cross the two portions of the skin, then forming a "fold". The animals remained with the owners, returning weekly for evalution. The application of bands has shown itself to easy and quick implementation. The animals remained with "Elizabethan" collar because it was observed itching in the first 72 hours after application of bands. There was no presence of bleeding or formation of infectious process in any of the procedures performed. The permanence of bands in the eyelid effectively, ensuring patency of eyelid margins, ranged between 5 and 12 weeks, with an average length of stay if 8 weeks. Some animals had to be reoperated and were followed until the final blepharoplasty. Complications are observed for the itching and the initial discomfort. The 2x8mm nylon abnd whether it is in material cheap, and integrity of ocular balls for 8 weeks on avarage and can thus be recommended its clinical use.(AU)

Blefarosplastia para correção de coloboma palpebral bilateral em um gato / Blefarosplasty for correction eyelid bilateral coloboma in a cat

O coloboma palpebral caracteriza-se por uma alteração congênita em que há a presença parcial das margens palpebrais ou a sua ausência. Diversos problemas oftálmicos secundários são comuns a tal afecção,dentre eles, a ceratite, vascularização de córnea, enoftamia, simbléfaro e geralmente é demarcada por um processo doloroso e conjuntivite. Este trabalho traz o relato de um coloboma palpebral bilateral em um felino, localizado em pálpebras superiores, que foi manejado cirurgicamente através de técnica deblefaroplastia por flap miocutâneo de pálpebra inferior. Como resultado houve o recobrimento da superfície ocular afetada de forma satisfatória e o animal em dois meses de pós-operatório não apresentava alterações oftálmicas.AU

The palpebral coloboma is characterized by a congenital alteration where there is the presence of partial eyelid margins or lack thereof. Several minor eye problems are common to this disease, among them,keratitis, corneal vascularization, enoftamia, symblepharon and is usually marked by a painful process and conjunctivitis. This paper presents the report of a bilateral eyelid coloboma in a feline, located on the upper eyelids, which was managed surgically via blepharoplasty technique by myocutaneous flap of the lower eyelid. As a result there was the ocular surface coating affected satisfactorily and the animal in two months postoperatively showed no ophthalmologic abnormalities.AU

Blefarosplastia para correção de coloboma palpebral bilateral em um gato / Blefarosplasty for correction eyelid bilateral coloboma in a cat

O coloboma palpebral caracteriza-se por uma alteração congênita em que há a presença parcial das margens palpebrais ou a sua ausência. Diversos problemas oftálmicos secundários são comuns a tal afecção,dentre eles, a ceratite, vascularização de córnea, enoftamia, simbléfaro e geralmente é demarcada por um processo doloroso e conjuntivite. Este trabalho traz o relato de um coloboma palpebral bilateral em um felino, localizado em pálpebras superiores, que foi manejado cirurgicamente através de técnica deblefaroplastia por flap miocutâneo de pálpebra inferior. Como resultado houve o recobrimento da superfície ocular afetada de forma satisfatória e o animal em dois meses de pós-operatório não apresentava alterações oftálmicas.

The palpebral coloboma is characterized by a congenital alteration where there is the presence of partial eyelid margins or lack thereof. Several minor eye problems are common to this disease, among them,keratitis, corneal vascularization, enoftamia, symblepharon and is usually marked by a painful process and conjunctivitis. This paper presents the report of a bilateral eyelid coloboma in a feline, located on the upper eyelids, which was managed surgically via blepharoplasty technique by myocutaneous flap of the lower eyelid. As a result there was the ocular surface coating affected satisfactorily and the animal in two months postoperatively showed no ophthalmologic abnormalities.

Blefaroplastia em coelhos por meio de cartilagem auricular alógena conservada em solução saturada de NaCl / Rabbits eyelid repair by means of alogen auricular cartilage preserved in NaCl saturated solution

Avaliou-se a reconstrução da pálpebra inferior de coelhos, com cartilagem auricular alógena, conservada em solução saturada de NaCl em 12 coelhos, adultos, de ambos os sexos. Os animais receberam acepromazina (0,5mg/kg/IM) e tiletamina e zolazepam (7,0mg/kg/IM), após o que removeu-se um fragmento de 1,0x0,5cm das pálpebras inferiores, esquerda e direita. A pálpebra esquerda foi reparada pela técnica de blefaroplastia em H (GC) e a direita por um retalho de cartilagem auricular associado a blefaroplastia em H (GE). Aos sete dias de pós-operatório (PO), as feridas cirúrgicas dos animais do GC apresentavam retração cutânea. Aos 15 dias de PO, observou-se que as feridas nos coelhos do GE estavam cicatrizadas, mas 30 por cento das do GC apresentavam deiscência e retração cicatricial. Aos 30 dias de PO, as feridas nos animais do GE e GC apresentavam-se cicatrizadas, mas, 30 por cento nos do GC não apresentavam as bordas das feridas coaptadas. O enxerto de cartilagem auricular diminuiu a retração cicatricial, possibilitando reparo anatômico à pálpebra(AU)

The rabbit inferior eyelid repair was evaluated using NaCl satured-stored alogenous auricular cartilage. Twelve adult male and female rabbits had a 1.0x0.5cm fragment removed from the left and right inferior eyelids after pre-medication with acepromazine (0.5mg/kgIM) and tiletamine-zolazepan (7.0mg/kgIM) anesthesia. The "H" plasty technique was used to the left eyelid repair (CG) and the right one was repaired with auricular cartilage associated with the "H" plasty technique (GG). The CG wounds presented cutaneous retraction at day 7th of the post-operative period. The GG wounds were healed on the day 15th, while the CG wounds presented 30 percent of deiscence and cicatricial retraction. The GG and CG wounds were healed at day 30th of the post-operative period, but 30 percent of the CG wounds did not present the edges lined up. It was concluded that the auricular cartilage graft decreases cicatricial retraction and improves anatomical eyelid repair(AU)

Eversão bilateral de terceira pálpebra em cão Relato de caso / Bilateral eversion of the third eyelid in a dog Case report

A eversão da terceira pálpebra é observada em algumas raças de grande porte, principalmente emcães jovens durante o primeiro ano de idade. Geralmente a causa desta condição é uma curvaturaanormal na porção vertical de sua cartilagem em forma de “T”. O presente trabalho relata o caso emum cão da raça dogue alemão, macho, com nove meses de idade que apresentou eversão bilateral deterceira pálpebra. O tratamento foi a excisão cirúrgica da porção vertical defeituosa da cartilagem.Após seis meses o animal não apresentou sinais clínicos de recidiva ou outras alterações oculares.(AU)

The third eyelid eversion is described in some large breeds, mainly in young dogs during the firstyear of age. Usually the cause of this condition is an abnormal curvature of its cartilage. This reportdescribes a male nine-months-old Great Dane with bilateral protrusion of the third eyelid. The treatmentwas surgical removal of the scrolled portion of the cartilage through the bulbar surface of themembrane. No clinical signs of relapse or other ocular complications were observed after six monthsfrom the procedure.(AU)

Eversão bilateral de terceira pálpebra em cão – Relato de caso / Bilateral eversion of the third eyelid in a dog – Case report

A eversão da terceira pálpebra é observada em algumas raças de grande porte, principalmente emcães jovens durante o primeiro ano de idade. Geralmente a causa desta condição é uma curvaturaanormal na porção vertical de sua cartilagem em forma de “T”. O presente trabalho relata o caso emum cão da raça dogue alemão, macho, com nove meses de idade que apresentou eversão bilateral deterceira pálpebra. O tratamento foi a excisão cirúrgica da porção vertical defeituosa da cartilagem.Após seis meses o animal não apresentou sinais clínicos de recidiva ou outras alterações oculares.

The third eyelid eversion is described in some large breeds, mainly in young dogs during the firstyear of age. Usually the cause of this condition is an abnormal curvature of its cartilage. This reportdescribes a male nine-months-old Great Dane with bilateral protrusion of the third eyelid. The treatmentwas surgical removal of the scrolled portion of the cartilage through the bulbar surface of themembrane. No clinical signs of relapse or other ocular complications were observed after six monthsfrom the procedure.

Transmissible venereal tumor: eyelid localization and blepharoplasty in a dog

Sebaceous gland adenoma, histiocytoma, mast cell tumor, papilloma, fibrosarcoma and melanoma are the most commoneyelid tumors. Eyelid venereal transmissible tumor (TVT) or Stickers tumor is not usual. This case reports a TVT in a lower eyeliddog. There was purposed a modificated H blepharoplasty with good cosmetic and therapeutic results.

Transmissible venereal tumor: eyelid localization and blepharoplasty in a dog

Sebaceous gland adenoma, histiocytoma, mast cell tumor, papilloma, fibrosarcoma and melanoma are the most commoneyelid tumors. Eyelid venereal transmissible tumor (TVT) or Stickers tumor is not usual. This case reports a TVT in a lower eyeliddog. There was purposed a modificated H blepharoplasty with good cosmetic and therapeutic results.