PMC9136284_01
Ocular surface findings. (A) Clinical photographs at the first visit. The left upper eyelid had slight keratinization, several aberrant lashes with clogged meibomian gland, conjunctival was congestions corneal epithelial punctate defect, perforation. (B) During the second month review after penetrating keratoplasty the patient presenting with small nodules accompanied with bleeding, burst and madarosis in the left eyelid margin. (C,D) During 1 year followup the corneal graft was transparent and the eyelid margin did not show any TLC recurrence and metastasis.
fmed-09-896393-g0001.jpg
PMC9136284_01_fmed-09-896393-g0001.jpg
F1
The most crucial observation was the presence of 1 x 2 mm sized aseptic corneal perforation existed in the central cornea, causing iris incarceration (Figure 1A). However, several small nodules gradually developed on the rough eyelid margin which accompanied with bleeding, burst and madarosis (Figure 1B). During 1 year follow-up period, there was no evidence of local recurrence and metastasis, and the corneal graft was transparent (Figures 1C,D).
Histological section demonstrating infiltrative lobules of clear cells composed of large, polygonal, clear cells with eccentric nuclei (Haematoxylin-eosin stain; magnification x200).
fmed-09-896393-g0002.jpg
PMC9136284_01_fmed-09-896393-g0002.jpg
F2
TLC, as the sections demonstrated classical large, polygonal, clear cells with eccentric nuclei and trichilemmal keratinization (Figure 2). TLC was immediately managed by lesionectomy.