OCULAR an‎d PERIOCULAR DERMOID CYSTS; A CLINICO-PATHOLOGICAL STUDY

The purpose of this study was to evaluate the different clinical presentations, morphology and management of dermoid cysts involving the eye and orbit. This is an interventional case series. All cases of ocular and periocular dermoid cysts operated between January 2000 and July 2005 were included in the study. Inclusion criteria were all peri-ocular swellings which had a histological diagnosis of dermoid cyst and were seen on the globe and near the orbital rim. Patients with medial and orbital dermoids underwent CT scan to rule out intracranial extension. Patients were followed up for 1 to 3 months to observed any recurrence. There were 36 cases of dermoid cysts out of which 7 were limbal, 11 medial orbital, 15 lateral orbital and 4 deep orbital. Two limbal dermoids were associated with pre-auricular skin tags. Most of the growths presented with slowly advancing lesions. Proptosis and displacement of the globe was produced by orbital and large medial dermoid. All cysts were removed completely and sent for histopathology. The cysts were lined with stratified squamous epithelium, underlying dermis and skin appendages. There was keratin, sebaceous material and hair inside the cavity. The orbital dermoids that to be drained before excision of the posterior wall. There was rupture of 2 medial dermoids while dissecting them from the periosteum. There were 3 referred cases of recurrent dermoid cysts out of which 2 were lateral and one orbital, which were removed successfully. Follow up was done from 1 to 3 months. There was late infection in one of the orbital dermoids which responded well to intravenous antibiotics. One patient with recurrent orbital dermoid had a frozen orbit on presentation which improved after surgery but she needed ptosis repair later. There was severe visual loss in one case of deep orbital dermoid. Inconclusion orbital dermoids should be removed carefully and completely to prevent recurrence and scarring of orbital contents