Mohammed Ather

Aim: The aim of this study was to study the cosmetic appearance of patients after Post-enucleation reconstruction of the orbit with silicone implant and dermis fat graft. Materials and Methods: this is a prospective interventional study conducted at the department of Oculoplasty and Orbital disorder of a tertiary care eye hospital between 2014 and 2016. 30 cases of which 16 were males and 14 females were included in the study. Patients between the age group 10- 40 years who had painful blind eye, anterior staphyloma and Pthisis bulbi were included in the study. Patients who had enucleation because of malignancies like retinoblastoma and malignant melanoma were excluded from study. Informed consent obtained from the adult patients and consent of one of the parent was obtained from patients who were under 18 years of age after explaining the procedure in patients own language. All patients included were examined by an experienced ophthalmologist using slit lamp, transparent scale, exophthalmometer, A scan, B scan. In single sitting enucleation was done, silicon spherical orbital implant was placed in orbit in posterior sub tenon’s space. Dermis fat harvested from upper and outer quadrant of buttock was placed over the Orbital implant in the posterior sub tenon’s space. Recti muscles were sutured to the edge of dermis fat and conjunctiva sutured to the edge of dermis fat. Conformer placed and Suture tarsorraphy done. Cases followed post operatively on day one, and after 2 week and after 3 months. Results: After 3rd month prosthetic eye was placed. Palpebral aperture height, enophthalmos and superior orbital sulcus deformity and cosmetic appearance was noted. 20 cases had 1mm difference in palpebral aperture height when compare to normal eye. 9 cases had 2mm, and one case had 4mm difference in palpebral aperture height. Enophthalmos with prosthesis was measured by exophthalmometer. 20 cases had 1mm of enophthalmos when compared to normal eye. 9 cases had 2 mm of Enophthalmos and one case had 4 mm of enophthalmos. 20 cases had fullness of superior orbital sulcus. 10 cases had 1-3 mm of superior orbital sulcus deformity. Cosmetic appearance was judged by doctors and attenders of patient. 20 cases had good cosmetic appearance. Whereas, 9 had fair cosmetic appearance and one had poor cosmetic appearance. Conclusion: It is concluded that doing enucleation and implanting orbital implant primarily along with Dermis fat graft reduces implant exposure to nil, and gives good cosmetic results as shown by measurement of Palpebral aperture height, Enophthalmos and Superior orbital sulcus deformity.   Keywords: Enucleation, Silicon Orbital implant, Enophthalmos, Superior Orbital Sulcus deformity

Aim: To study correlation between clinical features and histopathological exam of ocular surface squamous neoplasia. Materials and Methods: This is a Prospective interventional study conducted at the department of Oculoplasty of Sarojini Devi eye hospital between January 2012 to June 2013. 54 patients of freshly diagnosed OSSN were included in the study. Cases which were treated or had recurrence were excluded from the study. All the cases were examined by an experienced Ophthalmologist using Slit lamp, Snellen’s chart, Gonioscope and Direct Ophthalmoscope. Informed consent was obtained from all patients. After doing routine investigations like CBP, RBS, CT, BT, HIV, HbsAG patients were posted for excision biopsy of OSSN including 4mm of surrounding normal conjunctiva under local anaesthesia. Specimen was sent for Histopathological examination for diagnosis and margin clearance. Results: Out of 54 cases 36 were males and 18 were females. 21 had dysplasia, 15 had carcinoma in situ, 18 had Squamous cell carcinoma. 33 cases had out door occupation and 21 had indoors occupation. 27 had nodular type, 15 had Leucoplakic type and 4 had diffuse type. 21 cases had corneal involvement. HPE grades 3 had mild dysplasia, 6 moderate dysplasia, 12 had severe dysplasia, 15 had carcinoma in situ, 18 had Squamous cell carcinoma. 15 cases were HIV positive and 39 cases were HIV negative. Conclusion: Males out numbered females. Outdoor workers are more prone for OSSN. Nodular variety is commonest clinical type followed by Leucoplakic type and least common is diffuse type. Keywords: OSSN, Dysplasia, Carcinoma in situ, Squamous cell carcinoma.

Aim: To study the efficacy of intra lesional injection of triamcinolone acetonide in treating chalazion. Materials and Method: This is a prospective interventional study conducted on 100 cases of chalazion at the department of Oculoplasty and orbital disease of Sarojini Devi eye hospital, during July 2013 to June 2015. 100 cases of chalazion who came to the out patient department of Sarojini Devi Eye Hospital were included in the study. Recurrent cases, cases of acute hordeolum internum, Lid malignancies, and children were excluded from the study. Informed consent was obtained from cases selected. They were investigated for Routine surgical profile and size of chalazion measured in millimetres by a transparent ruler. Then Injection of 0.1 ml of triamcinolone was given intra lesionally into the chalazion in minor operation theatre taking all Aseptic Precautions. Cases were followed post operatively after Ist week and fourth week for reduction in size of chalazion. Result: Out of 100 cases 80 had complete resolution, 11 had reduction in size and 9 didn’t respond to treatment. Conclusion: Intra lesional injection of triamcinolone is Aesthetic method of treating chalazion.  Keywords: Chalazion, Intra lesional injection, Triamcinolone acetonide