Sagnik Sen

Impression cytology diagnosis of ulcerative eyelid malignancy

The utility of impression cytology in ocular diseases has predominantly been restricted to the diagnosis of dry eye, limbal stem cell deficiency and conjunctival neoplasias. Its role in malignant eyelid lesions remains largely unexplored. Although scrape cytology is more popular for cutaneous lesions, impression cytology, being non‐traumatic, has an advantage in small and delicate areas such as the eyelid. The present study has been designed to evaluate its role in the diagnosis and management of malignant eyelid lesions.

Giant orbital schwannoma with fluid–fluid levels

A 62-year-old lady presented with a large, right-sided orbital mass. It started as a small mass in the right lower lid 4 years back, which slowly grew in size. At presentation, she had no perception of light in the right eye. On examination, there was a 40×60 mm multilobulated intraorbital mass, causing massive proptosis and upward displacement of the globe. There was marked stretching and thinning of both the upper and lower lids and widening of the horizontal palpebral aperture. The tumour had a bluish colour at places and prominent vessels that were evident through the thinned out lids. The overlying skin was normal. On palpation, there was no tenderness or pulsations. The cornea was hazy precluding optimal posterior segment examination. The left eye had corneal opacity with cataract. The draining lymph nodes were not enlarged. CT and subsequent MRI of the orbit were done (figure 1A–C). Fine needle aspiration for cytology revealed serosanguineous fluid. Preoperatively, we aspirated 20 ml of serosanguineous fluid from the tumour, thus decompressing it. The tumour was excised piecemeal via anterior orbitotomy. As the orbital walls were extremely thinned out on imaging, we did not attempt to dissect the tumour from the periorbita that appeared to be intact even in areas of herniation. Therefore, some residual tumour was left behind. Excess of lid tissue was resected. Intraoperatively, we found large tortuous blood vessels within the tumour. Histopathological findings were diagnostic (figure 2). Figure 1 A) CT scan of the orbit (parasagittal) showing large, expansile, heterogeneous …

Comment on: Femtosecond laser-assisted cataract surgery versus 2.2-mm clear corneal phacoemulsification

The authors found that 1‐month postoperative endothelial cell loss (ECL) was higher with FLACS with no difference in postoperative central corneal thickness (CCT), without mentioning the intergroup P value. We applied parametric statistics to arrive at the intergroup P = 0.58 comparing the final CCT at 4 weeks. However, a percentage change of CCT in each group with comparative statistics should have been mentioned to arrive at the abovementioned conclusion.