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Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

Authors El Essawy R, Galal RE

Received 17 March 2013

Accepted for publication 2 April 2013

Published 28 May 2013 Volume 2013:7 Pages 955—958

DOI https://doi.org/10.2147/OPTH.S45351

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Rania El Essawy,1 Rasha Essameldin Galal2

1Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt

Background: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.
Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.
Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%).
Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.

Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

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