Original Article 

Surgical Management of Pediatric Limbal Dermoids With Sutureless Amniotic Membrane Transplantation and Augmentation

Amir Pirouzian, MD; Huck Holz, MD; Kevin Merrill, MD; Rattehalli Sudesh, MD; Kris Karlen, MD

  • Journal of Pediatric Ophthalmology and Strabismus
  • March/April 2012 - Volume 49 · Issue 2: 114-119
  • DOI: 10.3928/01913913-20110823-01

Abstract

Purpose:

To further evaluate the efficacy of a new surgical technique for removal of pediatric corneal-limbal dermoids and ocular surface reconstruction using multilayered amniotic membrane.

Methods:

Three pediatric patients with corneal-limbal dermoid (grade I) in one practice were identified in a retrospective fashion. All patients underwent deep lamellar excision followed by sutureless multilayered amniotic membrane transplantation by a single surgeon (AP). Preoperative and postoperative visual acuity, anterior segment examination, anterior segment B-scan, and cycloplegic refraction were performed.

Results:

Three patients with ages ranging from 6 months to 18 years had a postoperative follow-up of 9 to 12 months from the time of surgery. This surgical technique achieved rapid postoperative corneal re-epithelialization, reduced postoperative pain, and diminished postoperative scarring in all three patients. Existing preoperative astigmatism remained unchanged throughout the follow-up period. No intraoperative or postoperative complications were noted.

Conclusion:

This surgical approach offers an alternative surgical technique to a simple excision with or without deep lamellar keratoplasty for removal of pediatric corneal-limbal dermoids (grade I). In the management of pediatric limbal dermoids (grade I), surgical excision combined with sutureless multilayered amniotic membrane transplantation eliminates painful postoperative recovery and corneal neovascularization, and can achieve an improved long-term ocular surface cosmesis.

Authors

From the Department of Ophthalmology (AP), Gavin Herbert Eye Institute, University of California, Irvine; and Kaiser Permanente Medical Group (HH, KM, RS, KK), Santa Clara, California.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Amir Pirouzian, MD, Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, Med Surge I, Irvine, CA 92697. E-mail: apirouzi@uci.edu

10.3928/01913913-20110823-01

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