Surgical treatment of eyelid tumours
This article contains the information about the reasons, conditions, results, risks and limitations of an operation of an eyelid tumour
The eyelid tumour is usually a ball or flattened ball-shaped lesion of benign or malignant nature, localised on the eyelid.
Without effective treatment, the tumour may multiply or extend into the tissues of the eyelids and / or invade other tissues of the eye.
Some tumours contain viruses that can be responsible of chronic eye inflammations.
If the lesion is cancerous, it can spread in the body.
It is performed while the patient is installed on the back, in a sterile environment, under surgical microscope.
* Anaesthesia: it is done by an injection of anaesthetic near the lesion.
* Technique: The operation involves the total excision of the lesion. The chronological steps of the procedure are: Disinfection, anaesthesia by an injection in the area of the lesion, incision, removal of the abnormal tissue together with a safety area of healthy tissue, closure with stitches, disin-fection and, sometimes, laying of a protective eye pad or eye cup.
Depending on the location and size of the lesion, the Eye Doctor decides the type of anaesthesia, closure and post-operative treatment.
The total duration of presence in the clinic is approximately 1 hour. The time spent in the operating room is half an hour of which 10 to 20 minutes occur in the operating room.
The stitches, if any, are removed 1 to 4 weeks later.
If the lesion has an unusual appearance, an analysis in the laboratory of pathology can be performed to de-termine its exact nature. It is the patient’s responsibility to contact later the laboratory in order to get the results.
Usual postoperative course
The postoperative course is simple and lasts 1 week: slight haematoma, light swelling, mild to moderate pain and redness of the eyelid. Later, discrete to light stitches scars may remain.
Complications of the operation
Although it is perfectly standardized and followed by good results, this type of operation is no exception to the general rule that there is no surgery without risk. It is not possible for any ocular surgeon to ensure formally the success of a surgical inter-vention.
The patient should be aware that
* During the anaesthesia and sometimes despite the anaesthesia, during the operation itself, there is a hazard of discomfort and pain. This risk depends on the patient’s responsiveness to the anaesthetic molecule. This risk is unpredictable.
* In any local anaesthesia and all surgical procedures, there is a hazard of local complications, bleeding and in-fection and general intolerance that can lead to a severe shock. The risk of these complications is unpredictable. It is so exceptional that it is impossible to quantify.
* After any surgery of the skin, there is a hazard of inadequate or excessive scarring, which can lead to unaesthetic scarring. This risk is higher on dark skinned or regularly exposed to sunlight patients. This risk is not quantifiable.
* After any removal of tumour, there is a hazard of recurrence that may lead to further surgery. This risk is unpredictable but may be specified by the anatomopatho-logical (laboratory analysis) nature of the tumour.
To what must the patient be careful to, before, during and after the operation?
THE EVENING BEFORE THE OPERATION:
Any make-up should be removed. The hair and face, especially the eyelids and eyelashes, and the whole body should be washed with shampoo or soap then rinsed generously. The same thorough washing and rinsing should be repeated then the whole body should be dried with a clean towel. The sleep should be done with clean nightclothes and bedding. It is advisable not to take any Aspirin and other blood fluidifying drugs the day before and the day of the operation. Aspirin and other blood fluidifying drugs may be taken the day after the operation. The matter of Aspirin and other blood fluidifying drug should be discussed with the patient’s General Practioner.
THE DAY OF THE OPERATION AND DURING THE WEEK FOLLOWING IT:
On the morning of the day of the operation, upon awakening, any make-up residues should be re-removed carefully. The thorough double shower, as described above, should be repeated. Clean underwear and clothes should be worn. The breakfast and regular medications, except Aspirin and other blood fluidifying drugs, should be taken. All regularly taken medications should be brought to the Eye Clinic.
During the operation, the patient is requested to keep calm and strictly follow the instructions given by the Eye Doctor.
After the operation, the Eye Doctor prescribes eye drops or eye ointment, to be put on the operated eye, usually during 7 days.
The presence of an aiding person is advised during the remainder day of the operation.
A little bleeding and swelling (haematoma) of the eyelid should not worry nor keep the patient from following the treatment.
In case of pain, one to three Paracetamol tablets per day, for up to three days, may be taken.
It is, as always, strongly advised not to rub the eyes.
If a protective eye-pad is placed on the eye, it should be kept throughout night sleep or nap. The plasters should be changed after each application of ointment. The plasters stick best on a skin previously washed with soap or a gently rubbed with an alcoholic perfume.
Visual activities, professional and of leisure, are allowed as long as dirt and dust do not reach the eye.
Wearing sunglasses is, as always, advisable when exposed to sunlight.
The patient should contact the eye doctor immediately in case of:
* Breathing difficulties.
* General malaise.
* Persistent bleeding.
* Continued strong pain lasting more than 2 hours.