Prognosis after lamellar keratoplasty for limbal dermoids using preserved corneas

• Published in: Japanese journal of ophthalmology 2019-01, Vol.63 (1), p.56-64
• Main Authors: Yamashita, Kazuya, Hatou, Shin, Uchino, Yuichi, Tsubota, Kazuo, Shimmura, Shigeto
• Format: Article
• Language: English
• Subjects: Acuity; Adolescent; Astigmatism; Child; Child, Preschool; Clinical Investigation; Complications; Cornea; Corneal Diseases - pathology; Corneal Diseases - surgery; Corneal transplantation; Corneal Transplantation - methods; Cylinders; Demographics; Demography; Dermoid Cyst - pathology; Dermoid Cyst - surgery; Eye; Eye (anatomy); Eye Neoplasms - pathology; Eye Neoplasms - surgery; Eye surgery; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Lamellar structure; Limbus Corneae - pathology; Limbus Corneae - surgery; Male; Medicine; Medicine & Public Health; Occlusion; Ophthalmology; Organ Preservation; Patients; Prognosis; Retrospective Studies; Surgery; Surgical outcomes; Treatment Outcome; Visual Acuity; Visual observation; Young Adult
• ISSN: 0021-5155; 1613-2246
• DOI: 10.1007/s10384-018-0639-9

Purpose To evaluate the safety and efficacy of lamellar keratoplasty using preserved donor corneas to treat limbal dermoids. Study design Retrospective study. Methods The clinical records of 19 patients with limbal dermoids, who underwent lamellar keratoplasty using preserved corneas that were observed for more than 6 months at the Keio University School of Medicine between January, 2000 and December, 2017, were retrospectively reviewed. We retrospectively analyzed demographics, surgical outcomes, the occurrence of any surgically induced changes in refraction, and intra and postoperative complications. Results Patient age at surgery showed 2 peaks, the first ranged from 0 to 6 years, and the second from 13 to 20 years. All patients except one had good cosmetic results. Preoperative astigmatism was more than 2 diopters in 12 of 16 eyes for which refractive data were recorded. The refractive cylinder in 8 of the 16 eyes differed after surgery by less than 2 diopters. Treatment of amblyopia by occlusion of the fellow eye and spectacle prescription was done either prior to or following surgery, and resulted in improved visual acuity in 7 patients. Intraoperative complications did not occur in any of the patients. Postoperatively, all patients except one showed corneal re-epithelialization within a week. Conclusion Lamellar keratoplasty using preserved corneas for limbal dermoid yields good cosmetic results. However, improvements in astigmatism and visual acuity are not guaranteed. Preoperative treatment of amblyopia gives a better prognosis for improved visual acuity postoperatively. Long-term observation including amblyopia treatment is required before and after surgery.