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.
|Published (Last):||15 November 2010|
|PDF File Size:||19.53 Mb|
|ePub File Size:||4.98 Mb|
|Price:||Free* [*Free Regsitration Required]|
They also suggested that early surgery with simple local resection combined with a conjunctival flap in order to cover the exposed area may be preferred to lamellar keratoplasty.
Management of pediatric corneal limbal dermoids
Nevertheless, our preliminary results are promising, and we believe that Mitomycin C is a viable option demroid limbal dermoid surgery. Double vision motility restriction or strabismus Dry eye exposure due to coloboma or large dermoid. Fibrin-glue assisted multilayered amniotic membrane transplantation in surgical management of pediatric corneal limbal dermoid: Chronic eye rubbing due to irritation and recurrent derkoid. Graefes Arch Clin Exp Ophthalmol. Median follow-up was 17 months.
Microperforations were noted in three eyes on excision of the dermoid. Extensive corneal defects appear to show improved healing following multilayered amniotic membrane transplantation and augmentation. Males are more affected than females in a 2: With regards to the role of the ophthalmologist, fermoid 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.
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. Amniotic membrane transplantation for ocular surface reconstruction. The role of ultrasound biomicroscopy in surgical planning for limbal dermoids. Grade II limbal dermoids are of larger size and extend into the corneal stroma down to Descemet’s membrane.
Amniotic membrane transplantation in ophthalmology fresh v preserved tissue Br J Ophthalmol.
Management of pediatric corneal limbal dermoids
These authors considered that this technique minimized the complications associated with large corneal transplants and increased the chance of long-term success. Simple excision of grade I and II corneal dermoids has typically been shown to result in a persistent epithelial defect, corneal vascularization, and scar formation, which is now thought to occur as a result of a cascade of events related to focal marginal limbal stem cell deficiency at the site of dermoid excision.
Three patients had a diagnosis of Goldenhar syndrome. Major risks of the excision deroid the limbal dermoid are intraoperative perforation, postoperative epithelial defects and peripheral vascularization of the cornea. The data of 12 consecutive patients 14 eyeswho underwent monocentric surgery of a limbal ,imbal in the past der,oid years, were retrospectively analyzed for intra and postoperative complications.
This paper reviews the data in the published literature PubMed from to limbl the medical and surgical management of pediatric limbal dermoids. The constellation of bilateral limbal dermoids, eyelid coloboma, ddermoid preauricular skin tags was consistent with a diagnosis of Goldenhar syndrome.
How does amniotic membrane work? Vision is often impaired from astigmatic refractive errors caused by corneal astigmatism. The geneticist noted very subtle hemifacial microsomia, with the right side of the patient’s face being slightly smaller than the left. The use of mitomycin Dermpid with autologous limbal-conjunctival autograft transplantation for management of recurrent pterygium. The limbal dermoid on the left side has not changed in size, does not threaten the visual axis and does not inhibit closure of the lids see Figure 2B and 3.
Isolation of new fractions of antitumor mitomycins. Introduction Limbal dermoids rank among the most common tumors of the corneal limbus. They reported all but 16 eyes improved cosmetically.
Given this, surgical removal of the limbal dermoid on the left side can be postponed indefinately. The use of amniotic membrane transplantation in the removal of a limbal dermoid has recently been described by others. All the patients showed reduction in astigmatism and eyes improved functionally. Lazzaro DR, Coe R. Gorlin RJ, et al.
Goldenhar Syndrome (Oculo-Auriculo-Vertebral Spectrum):
Low-dose intraoperative mitomycin C as chemoadjuvant for pterygium surgery. Limbal stem cell deficiency with a pseudopterygium developed in four eyes, one treated lombal bare-sclera excision and the others with amniotic membrane transplantation.
Technique for the removal of limbal dermoids. The histopathological examination confirmed the diagnosis of a solid limbal dermoid in all cases. By the age of 10 months, the mother began to dermpid that the eyelid in the right eye would “hang up” on the limbal dermoid.
Genetics and inheritance The pattern of inheritance is quite variable in epibulbar choristomas.
Published online Mar The syndrome is almost always diagnosed early in life, before there is any complaint of symptoms by the infant patient. Peripheral blood analysis revealed a normal 46,XY karyotype. Treatment of epibulbar limbal dermoids. The patient was given appropriate spectacle correction in his first months of life.
Seven patients were afflicted with discomfort of the affected eye. Footnotes Disclosure The author reports no conflicts of interest in this work.
Clinical evaluation and surgical intervention of limbal dermoid.