Congenital uveal malignant melanoma- A rare case report.

Purpose: To report a rare case of congenital uveal malignant melanoma from Indian subcontinent in an infant with multiple cutaneous naevi and no distant metastasis. Observation: An 8 month old male child presented with proptosis and black discoloration in the right eye since birth. Enucleation of the right eye was performed and specimen sent for histopathology and immunohistochemical analysis. Results were strongly suggestive of a malignant melanoma of uvea. No metastasis was found on MRI scan of brain, chest and abdomen. Patient is on close follow up and will be subjected to metastasis workup every 6 months. Conclusion and importance: This entity of congenital uveal malignant melanoma is rather rare with very few reported cases across the globe and needs further understanding of its correct line of treatment.

Reestablishing Lacrimal Drainage by Canaliculorhinostomy after Dacryocystectomy: A Viable Option in Symptomatic Patients.

PURPOSE: To evaluate the outcome and efficacy of a modified technique of canaliculo-dacryocystorhinostomy (canaliculo-DCR) in the complete absence of lacrimal sac, as a means to reestablish lacrimal drainage in postdacryocystectomy (post-DCT) patients. METHODS: A retrospective, nonrandomized interventional study including 15 proven and established post-DCT patients with intact canaliculi of at least 7 to 8 mm. The patients presented with bothersome tearing to the oculoplastic clinic from January 2017 to January 2018. Patients were operated by a single surgeon (ST). Procedure involved creating a bony ostium of optimum size, internal membranectomy and the nasal mucosal flap anchored appropriately to create a passage in line with the common canaliculus. Adjunctively bicanalicular intubation and mitomycin-C were used. RESULTS: Of the 15 patients who were operated (10 female and five male patients), 14 (93.33%) had functionally and anatomically patent lacrimal passage after the modified canaliculo-DCR, one (6.66%) was symptomatically better with partial regurgitation of clear fluid. Three (20%) had tube prolapse after 1st month postoperatively, which although significant, was not related to the technique. They were repositioned as an office procedure and retained thereafter till removal, no other tube related or mitomycin-C related sequelae was seen. No intraoperative complication was encountered. CONCLUSIONS: With a success rate of 93.33% and a resultant patent lacrimal tear drainage passage and trivial complication such as tube prolapse, we can conclude, this technique of modified canaliculo-DCR in post-DCT patients is a safe and effective procedure with promising results, thereby avoiding cumbersome methods and maintenance of Jones tube while at the same time providing symptomatic relief to the patients.

Epiblepharon in East asian patients: the singapore experience.

PURPOSE: To describe the demographics, presenting symptoms, indications for surgery, and surgical outcomes of epiblepharon correction in a tertiary care hospital in Singapore. DESIGN: Retrospective review of patients who underwent surgery by 2 surgeons in a referral oculoplastic practice at the National University Health System, Singapore, from 2001 to 2007. PARTICIPANTS: A total of 108 patients who underwent surgery for clinically significant epiblepharon. INTERVENTION: Modified Hotz procedure or suture correction for patients in whom conservative treatment failed. MAIN OUTCOME MEASURES: Comparison of symptoms, keratopathy, and recurrence on follow-up between the 2 procedures. RESULTS: The mean age of the patients was 9.0 years, with an age range of 0.5 to 68 years. Of the patients, 51.9% were male. The majority were Chinese (n = 102). Seventy-four (68.5%) patients were symptomatic. Eighty-nine patients (82.4%) had keratopathy. In 98 patients (90.7%) both eyes were affected, and the majority of patients (75.0%) had epiblepharon of the lower lids. Initial treatment for the majority was lubricants (n = 71, 65.7%). The main indications for surgery were symptoms and keratopathy, with 37.9% of patients having both, and 44.4% and 15.7% of patients having either keratopathy or symptoms alone, respectively. Surgical correction consisted mostly of a modified Hotz procedure (n = 88, 81.5%), lid-everting sutures (n = 9, 8.3%), and others, including upper lid blepharoplasty with lid crease formation (n = 11, 10.2%). Outcomes were good, with the majority (n = 88, 81.5%) of lids being well corrected. Complications included undercorrection, overcorrection, wound dehiscence, and wound infections. CONCLUSIONS: Symptomatic epiblepharon, usually associated with keratopathy and commonly seen in children of East Asian descent, often requires surgical intervention with good surgical outcome. Increased awareness among ophthalmologists and pediatricians dealing with this ethnic group and age is emphasized. Contrary to the current practice of expectant observation, definitive surgical management should be considered when symptoms or keratopathy is present. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.