[Study of the cutaneous scar after external dacryocystorhinostomy]. / Étude de la cicatrice cutanée de la dacryocystorhinostomie par voie faciale.

AIM: To objectively analyze the cutaneous scar after external dacryocystorhinostomy and to compare the cosmetic result of a nasal incision and an inferior eyelid incision. PATIENTS AND METHODS: All patients consecutively operated between January 2007 and December 2009 were notified of an examination. The cutaneous scar was photographed and de visu analyzed by the two authors who gave marks : 20, no visible scar ; 10, visible scar but cosmetically considered not detrimental ; 0, visible scar and considered unesthetic. RESULTS: Eighteen of the 60 patients notified came for examination. One hundred percent of ten patients operated via an inferior eyelid incision were graded 20 versus 25% of eight patients operated via a nasal incision. Of these patients, 62.5% were graded 10. Only one patient was marked 0 (nasal incision). DISCUSSION: The inferior eyelid incision seemed to give much better cosmetic results than the nasal incision.

[Modified evisceration for biocolonizable orbital implant: the four-square technique]. / Eviscération modifiée pour implant orbitaire biocolonisable: la technique des "quatre carrés".

INTRODUCTION: The introduction of a porous, biocolonizable, orbital implant is difficult after a classic evisceration. We have developed a modification of the method that provides better results. MATERIAL AND METHODS: Four scleral squares pediculized on the right oculomotor muscles were cut. They were sutured two-by-two over the anterior part of the implant. RESULTS: Fifteen patients were operated. There were no complications during a mean follow-up of 12.4 months. DISCUSSION: The soft anterior tissues were protected by the two vascularized scleral layers. The diameter of the implant was 18 mm for three patients, 20 mm for eight patients, and 22 mm for four patients. Operating time was much shorter than with enucleation and covering of the implant with autologous sclera. CONCLUSION: Evisceration with the four-square technique is a safe and quick method, which can be used for most patients, except those with an intraocular neoplasia.

[Molluscum contagiosum of the eyelid]. / Molluscum contagiosum de la paupière inférieure.

A 6-year-old girl had a single molluscum contagiosum of the lower eyelid. Clinically, the tumor had grown slowly since it had been discovered 8 months before the child was seen at our consultation. It appeared as a nodular lesion on the middle part of the eyelid. Its surface was irregular and its color was the same as the epidermis. It was surgically excised, using the shaving biopsy technique. Its histopathological study showed a papillomatous lesion with the typical features of a molluscum contagiosum. The patient was lost to follow-up soon after the surgery.

[Chalazion mimicking an eyelid tumor]. / Forme pseudotumorale d'un chalazion.

A 3-year-old girl had a tumor growing for a month on the superior right eyelid, attached on the free margin of the eyelid and partially necrotic. A surgical excision was performed under general anesthesia. The histopathological study found an inflammatory lesion with epithelioid and giant cells, evidence of a granuloma, suggesting the diagnosis of chalazion. This case shows the various clinical presentations of this common and benign disease of the eyelid.

[Pleomorphic adenoma mimicking dacryoadenitis]. / Adénome pléomorphe simulant une dacryoadénite.

A 56-year-old female patient displayed an increased volume of her left lacrimal gland with pain and inflammation. On CT scan, a hyperdense lacrimal mass was found in the left lacrimal fossa. Observation was the first course, for no steroid therapy could be applied because of evolving digestive ulcers. After 9 months of observation, the gland was surgically removed en bloc through a wide anterolateral approach. Pathological analysis of the gland showed a pleomorphic adenoma. This case illustrates the advantage of a wide surgical approach in treating lacrimal gland tumors, in order to avoid or limit the risk of recurrence.

[Conjunctival pyogenic granuloma in a patient with chalazions]. / Granulome pyogénique de la conjonctive palpébrale chez un patient porteur d'un chalazion. A propos d'une observation anatomo-clinique.

A 28-year-old male patient had a chalazion on his left eyelid. Increased discomfort led to the discovery of a conjunctival mass under the inner part of his upper eyelid. On clinical examination, a small reddish mass on the palpebral conjunctiva of the upper left eyelid was only visible on the underside of the lid; the mass was diffusely reddish. Additionally, a chalazion was present in the middle of the lower left eyelid. As this condition was a source of discomfort to the patient, the mass was surgically resected. The histological study found a typical pyogenic granuloma, a possible complication in the course of a chalazion.

[Corneal edema in pseudophakia. A case report]. / Oedème cornéen du pseudophake. A propos d'une observation anatomo-clinique.

Pseudophakic bullous keratopathy is one of the most common complications of intraocular lenses, which explains the high rate of this condition in series of patients experiencing corneal grafts. It is caused by irreversible damage to the endothelial layer of the implanted eye involving the artificial lens, and occurs either during cataract extraction or after the operation. Intraoperative endothelial protection and the choice of an appropriate lens may contribute to decreasing this secondary disease, which can have severe consequences for many patients whose corneal graft may not restore their visual potential as well as expected. We report a clinicopathological case of a 59-year-old male, previously operated on for cataract in both eyes with an anterior chamber lens. A bilateral corneal edema occurred a few years after the operation, with a bilateral decrease in vision as a consequence. A corneal graft was performed in 2000 on the left eye in order to improve the patient's visual autonomy. The best treatment of this condition remains prevention, avoiding the use of this type of intraocular lens, whose main complication is corneal edema.

[Conjunctival semi-lunar fold nevus of presumed late onset]. / Naevus du repli semi-lunaire de la conjonctive de découverte tardive.

Conjunctival nevi are lesions observed commonly occasionnally and can be found later in a life. Such a lesion was observed on the conjunctival semilunar fold in a 76-year-old female patient. It was oval in shape, pigmented, and was mainly visible when the affected eye was in abduction. As no accurate anterior clinical history was available, surgical resection was performed. Hitopathological study disclosed a subepithelial nevus, which was completely resected. Regular follow-up was recommended, as is usual after surgical resection of a conjunctival pigmented tumor.

[Pseudotumoral eyelid inflammation. Apropos of an anatomo-clinical case]. / Inflammation palpébrale pseudotumorale. A propos d'une observation anatomo-clinique.

A clinicopathological case of a 76-year-old male patient with a chronic inflammatory change of the inferior left eyelid is reported. The inflammation appeared as a reddish area of the inner part of the eyelid, without sharp limits, but with loss of lashes. Numerous local treatments did not to cure this condition. As some true eyelid tumors may mimic an inflammation during growth and, for example, sebaceous carcinoma may clinically present as chronic unilateral blepharitis, a surgical excisional biopsy was performed on this left eyelid. Its histopathological study showed a granulomatous inflammation, which was typical of a simple chalazion. This case clearly illustrates that the chalazion may not always appear as a limited nodular inflammation of the eyelid, but may have a more diffuse clinical presentation.

[A cutaneous horn of the free margin of the eyelid: an anatomical and clinical observation]. / Corne cutanée du bord libre palpébral. A propos d'une observation anatomo-clinique.

A cutaneous horn was observed close to the free margin of the inferior right eyelid in a 26-year-old-male patient. A minimal resection was primarily performed. Histopathologic study disclosed a precancerous keratosis. As the tumor had not been entirely excised, a complementary resection was performed secondarily to obtain the entire resection of the tumor.

[Hypertrophic eyelid conjunctival scar. A tarsal keloid]. / Cicatrice hypertrophique de la conjonctive palpébrale ou chéloïde de la conjonctive tarsale. A propos d'une observation anatomo-clinique.

The clinicopathologic case of a 53-year-old female patient with an abnormal tumor growing on the mucous part of the superior right eyelid is reported. The patient was operated on for ten years ago and a whitish mass slowly developed on the conjunctival face of the eyelid disturbing the use of corneal lenses. It was hard, painless and had the shape of a flat mushroom. The removal was performed under local anesthesia and allowed us to resect a hard and fibrous lesion. Histopathology showed that the lesion was made of a fibrous tissue organized like a hypertrophic scar. Surgical treatment of chalazion is frequent and rarely gives rise to abnormal scarring.

[Inflammatory pseudotumor of the caruncle]. / Pseudotumeur inflammatoire de la caroncule.

A 6-year-old girl exhibited a recent caruncular tumor which was increasing in size. It was removed after a CT scan had showed a both medial and superficial mass. Fortunately, histological tests only found inflammatory cells attesting that the mass was due to an inflammation of this area. Inflammation is one of the different processes that may increase the size of the caruncle, but sometimes, only histopathology can provide conclusive evidence.

[Multilocular eyelid hidrocystoma: an anatomical and clinical observation]. / Hidrocystome multiloculaire palpébral: à propos d'une observation anatomo-clinique: à propos d'une observation anatomo-clinique.

A cystic cutaneous mass was observed on the lateral canthus of the left eyelid in a 25-year-old woman, 2 years after being operated on for a lesion that had existed in the same area several years before, but the patient could not identify its nature. The present mass appeared as a well-circumscribed bluish cystic lesion. A surgical resection was performed; pathological analysis disclosed a cystic sweat tumor composed of several contiguous cysts. One year of follow-up has revealed no complications.

[Bilateral keratoconus: a case report]. / Kératocône bilatéral évolué

Among corneal dystrophies, the keratoconus is one of the most frequently observed among young adults. A clinico pathological case is reported in a 13-year-old-girl of African origin. The diagnosis of bilateral keratoconus was established based on the obvious changes of the corneal curvature and thickness. After an unsuccessful attempt to improve vision with contact lenses, a keratoplasty was finally performed on one side to remove the pathological cornea. Its histopathological study found the characteristic changes of keratoconus: breaks of Bowman's layer and corneal thinning.

[Followup of chicken pox keratitis. Anatomic-clinical case report]. / Kératite varicelleuse séquellaire.

Chicken pox is a very common infectious disease in children. Its corneal involvement is less serious than with measles, which may lead to blindness in numerous developing countries. However, with occasional cases occur. A case of a 59-year-old male patient whose left cornea was involved during a chicken pox infection at the age of 7 is reported. More recently, the vision of the right eye was normal at 20/20 and reduced to visual perception in the affected left eye. Corneal sensitivity was maintained in the left eye, which, however exhibited a central epithelial defect. A central round opacity of the left corneal stroma was believed to be the scar resulting from a previous disciform keratitis. The left central cornea was thinned and there was neither an anterior chamber flare nor new corneal vessels. This corneal condition required a corneal allograft, performed quickly because of the potential risk of perforation. Histopathological study of the corneal button showed a central corneal thinning with an increase in epithelial thickness. The corneal stroma was disorganized, with irregular collagen bundles. No inflammatory cells could be observed, however. All the histopathological changes observed were those of a corneal scar.

[Nevus mimicking a basal cell carcinoma of the eyelid]. / Naevus naevocellulaire achrome palpébral prenant l'aspect d'un carcinome basocellulaire.

A clinicopathologic case of a 41-year-old female patient exhibited a single cutaneous tumor at the inner part of the free margin of the inferior left eyelid. It was a pink, fleshy, and nodular well-circumscribed exophytic mass with thin vessels on its surface. Experienced already for 20 years, this lesion had been observed 6 years before and has not exhibited much change since then. However, its clinical appearance argued for a possible small basal cell carcinoma, which had grown over the inferior left lachrymal duct. After surgical removal, histopathology showed that the tumor was an amelanotic dermal nevus. No disturbance of lachrymal drainage was observed after surgery. This case shows that nodular amelanotic tumors of the eyelid, even when located on the inner segment of the eyelid, may be a nevus.

[Basal cell carcinoma associated with a squamous cell papilloma at the inner part of the eyelid]. / Carcinome basocellulaire associé à un papillome de l'angle interne de la paupière.

There are numerous variants of cutaneous tumors involving the eyelids. Tumors of a different nature may at times be observed simultaneously in the same area of the eyelid. A clinicopathologic case of a 36-year-old male patient with 2 different cutaneous tumors at the nasal part of the left eyelid is reported. One was a nodular tumor on the inner canthus with a pearly appearance; the other had a papillomatous pattern. After surgical removal, the histopathological study of the tumors disclosed a typical basal cell carcinoma and a squamous cell papilloma. Both tumors can be commonly observed on the eyelids and surgical excision cured the patient.

[Eyelid neurofibroma affecting a young woman]. / Neurofibrome palpébral chez une femme jeune.

A 43-year-old female patient had an amelanotic single tumor thickening the upper right eyelid and observed since early childhood. Clinically, it appeared as a firm mass, without sharp margins, giving a thickened appearance to the superior eyelid. The ophthalmic clinical examination was normal but some subcutaneous nodules attested to the diffusion of the disease recognized as a limited form of neurofibromatosis 1. Although well tolerated, it gave rise to a cosmetic disturbance and the patient was willing to undergo an excision. A complete surgical excision was performed on the lesions and the pathological study disclosed a typical neurofibroma. Regular observation of the different cutaneous nodules was recommended.