Surgical management of pediatric limbal dermoids with sutureless amniotic membrane transplantation and augmentation.

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.