Abstract
Purpose
To compare the outcomes of three techniques for removing internal angular dermoid cysts: lid crease, sub-brow, and direct mini-incision.
Methods
In this single-center trial, 47 children with internal angular dermoids were enrolled and randomly assigned to one of three surgical groups: group A, sub-brow, group B, lid crease, and group C, direct mini-incision. Outcome measures were operative time, postoperative scar quality using Stony Brook Scar Evaluation Scale (SBSES), scar visibility, and family satisfaction.
Results
In each group, fifteen patients completed follow-up and were analysed. The operation time (median/IQR) in Group C was significantly shorter (10/5 min) compared with group A (25/10 min) and B (35/20 min) (p < 0.001). Group B had the least visible scar at all follow-up visits. Both group B and C showed superior scar quality using SBSES compared with group A at 6 months (p < 0.001). All families in group B (100%) found the scar excellent compared to 11 families in group C (40%) and 6 families in group A (73.3%). Persistent postoperative inflammation was noticed in two patients in group C. No cases of recurrence were recorded.
Conclusions
Both the lid crease and direct mini-incision approaches result in superior scar quality with minimum visibility compared with the sub-brow technique, however, the lid crease technique shows a prolonged operation time particularly for cysts outside the rim.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Change history
19 January 2022
A Correction to this paper has been published: https://doi.org/10.1038/s41433-021-01915-1
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The authors confirm contribution to the paper as follows: study conception and design: DMM, EKB, ARC, AGAE; data collection: DMM, EKB; analysis and interpretation of results: DMM, EKB, ARC, AGAE; draft paper preparation: DMM, EKB. All authors reviewed the results and approved the final version of the paper.
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The original version of this article was revised: In part Objective scar visibility (patient’s eyes open) and part Stony Brook Scar evaluation (patient’s eyes closed) the Kruskal-Wallis test was named incorrectly as chi-square test.
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Diab, M.M., Allen, R.C., Abdel Ghafar, A.E. et al. Comparison of three surgical techniques for internal angular dermoid cysts: a randomized controlled trial. Eye 36, 2253–2259 (2022). https://doi.org/10.1038/s41433-021-01851-0
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DOI: https://doi.org/10.1038/s41433-021-01851-0
