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Limbal dermoids rank among the most common tumors of the corneal limbus. They are ocular choristomas and can occur in a variety of sizes. Images in Clinical Medicine from The New England Journal of Medicine — Limbal Dermoid. Images in Clinical Medicine from The New England Journal of Medicine — The Hairy Eyeball — Limbal Dermoid.

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All patients had been treated consecutively in the past 9 years.

Goldenhar Syndrome (Oculo-Auriculo-Vertebral Spectrum):

Nevertheless, our preliminary results are promising, and we believe that Mitomycin C is a viable option in limbal dermoid surgery. Open in a separate window. Basic and Clinical Science Course. One of these cases developed graft infection, underwent subsequent debridement, and had an opaque graft.

Management of pediatric corneal limbal dermoids

Pre and postoperative photographical data were available for all patients Figures 1a and b, and 2a and b. The patient was followed closely in our clinic during this time.

External image at 3 years of age shows a clear visual asis in both eyes, the right der,oid eyelid coloboma, and the limbal dermoids at the temporal limbus of the left eye, unchanged since infancy. InBourne treated a series of four pediatric patients with grade II limbal dermoid by direct excision followed by lamellar keratoplasty using a 5—7 mm trephine with a good limnal.

Open in a separate window. Of a total of 11 patients with deep corneal ulcers, The astigmatism persisted postoperatively, with little change in orientation or amount, regardless of patient age at the time of surgery. Amniotic membrane transplantation for ocular surface reconstruction. Our reason for using amniotic membrane was to achieve a reduction of postoperative inflammation and scarring.

The amniotic membrane is known to limnal into conjunctival epithelial cells, and amniotic membrane tissue provides a natural biological substrate for indigenous corneal stromal growth and epithelial cell differentiation with subsequent reduction in postoperative scar formation.


Treatment of epibulbar limbal dermoids. This entity was further described as the oculo-auriculo-vertebral spectrum ten years later Gorlin, Finally a smoothing of the corneal surface was performed if necessary. Burillon et al 5 reviewed the records of 12 patients with solid ocular tumors between andreporting that six lesions could be easily shaved off the cornea and liimbal sclera to improve the appearance of the eye.

The light reflex from this photograph gives the appearance of a small exo-deviation, but cover-uncover and alternate-cover testing showed the patient to be orthophoric. They also anticipated reduced scarring due to faster reepithelialization. Abstract This paper reviews the data in the published literature PubMed from to concerning the medical and surgical management of pediatric limbal dermoids.

Invest Ophthalmol Vis Sci. This was the patient’s first presentation for eye care. When any of the above conditions or combination of conditions is noted, surgery should be considered and thoroughly discussed with the parents, including the potential risk of scarring, the requirement for ongoing treatment of amblyopia after surgery, need for spectacle or contact lens wear, possible repeat surgery, and loss of vision. Notes The authors declare no conflict of interest.

Postoperative treatment included antibiotic eye drops and artificial tear eye drops until reepithelialization occurred. Journal List Clin Ophthalmol v. The pattern of inheritance is quite variable in epibulbar choristomas. The use of mitomycin C with autologous limbal-conjunctival limval transplantation for management of recurrent pterygium.

The indication for the surgery was an increase in the size of the dermoid in three patients. Epibulbar dermoid tumours of the corneal limbus treated by lamellar keratoplasty. Clinicopathologic features of excised mitomycin filtering blebs.

Seven eyes were treated by removal of the limbal dermoid by lamellar excision without further procedures. Zaidman et al reported on two-stage excision of a protuberant congenital corneal dermoid that extended into the anterior chamber in an infant aged one month.

The most common location for epibulbar dermoids is the temporal inferior quadrant of the limbus. Grade II limbal dermoids are of larger size and extend into the corneal stroma libmal to Descemet’s membrane.


Clinical evaluation and surgical intervention of limbal dermoid. March 31, ; Available from: Panda also commented on advances and research on fresh versus preserved amniotic membrane transplantation in ophthalmology. Outcome of lamellar keratoplasty for limbal dermoids in children.

The patient was born at 36 weeks gestation and was delivered by normal spontaneous vaginal delivery NSVD. Double vision motility restriction or strabismus Dry eye lmibal due to coloboma or large dermoid TREATMENT Large eyelid colobomas resulting in exposure keratopathy may require surgical repair Spectacle Superficial keratectomy may be required to excise large limbal dermoids causing occlusive or astigmatic amblyopia or exposure Cleft lip and palate will require surgical repair, if present Severe underdevelopment of the mandible may require reconstruction, perhaps with the aide of a bone graft i.

No eye treated with Mitomycin C developed a postoperative pseudopterygium Drrmoid 4.


Surgical complications included prolonged re-epithelialization, interface neovascularization, graft rejection, and steroid-induced glaucoma. Then the complete lamellar en bloc excision of the corneal and scleral parts of the dermoid was performed including the removal of the entire adjacent conjunctiva. With regards to the role of the ophthalmologist, treatment is directed first at strong amblyogenic risks including obstruction of the visual axis, severe astigmatism, or strabismussecond at ocular exposure due to large lid coloboma or limbal dermoid preventing lid closureand third at working with craniofacial surgeons in cases severe microsomia that requires reconstruction of the upper face.

A family with dominant oculoauriculovertebral spectrum. Shortly after delivery, he was noted to have bilateral “fleshy masses” on the corneas and an irregular right upper eyelid.

Articles from Clinical Ophthalmology Auckland, N. The geneticist noted very subtle hemifacial microsomia, with the right side of the patient’s face being slightly smaller than the left.