Whenever I told somebody that I am an eye surgeon specializing in eyelid surgery, the reaction is invariably: "Oh, so you specialize in double eyelid surgery". I always try to correct them by saying: "Actually, I also manage other eyelid conditions such as eyelid cancer etc etc". The reaction is usually: "I never know you can get cancer in the eyelids".
Compared with the Europeans, eyelid tumour is not as common in Malaysia but in Kuching I come across three to four cases per month. Most of these cases usually present late with extensive tissue destruction (more on these cases in future blog). Below is an 80 year-old native woman who presented with a rapidly growing left upper eyelid tumour. There was destruction of the eyelashes and the appearance is strongly suggestive of sebaceous cell carcinoma. I performed excision of the lesion with clear margin followed by one-stage reconstructio using reversed McGregor's flap using the principle of Z-plasty.
A destructive lesiono f the upper eyelid occluding the vision.
Marking of the eyelid to determine the amount to be excised
and reconstruction after the excision.
After removal of the eyelid tumour with clear margin.
About half of the upper eyelid was removed.
A reversed McGregor's flap mobilizing the tissue from the
temporal side of the orbit was used to cover the defect.
Closure of the defect after mobilizing the tissue from the
temporal side of the orbit.
At the conclusion of the surgery, the eyelid will take about 3
to 4 weeks to return to its near normal shape and size.
Note the transposition of the tissue in the orbit as
evidenced by a changein the position of the Z.
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