Clinical Observation Of Therapeutic Lamellar Keratoplasty For Limbal Dermoids

limbal dermoids are congenital benign tumors consistingof tissues of ectodermal and mesodermal origin. They may bestationary or slowlygrowing and appear as raised yellowishwhite finely vascularizedbulbous lesions. The most commonsite for a limbaldermoid is in the inferotemporal quadrant. Theyoccur more commonly as single lesions but may be multiple,and they may be unilateral or bilateral, the former being themore common.Surgery is the unique effective therapy. 22 patients (13 female, 9 male, age range, 8 months–20years) with 23 limbal dermoids in 22 eyes who underwentlamellar keratoplasty between 1984 and 2005 were identifiedfrom database at the third affiliated hospital of Jilin university toassess the surgical outcomes of appearance, vision, graftsurvival and integrity,surgical complication in patients withhistologically proven limbal dermoid choristomata.1.cure rate and recurrent rateWe made detailed check-up before operation to ensurecomplete dissection of the tumor and excised the lesioncompletely during the operation. The cure rate was 100percent.And the recurrent rate was 0.2.apperance and graft survivalMost (19 of 22) patients had excellent cosmetic resultsand clear graft with inperceptible interface haze and novascularization. 2 cases with previously excised lesions hadgood cosmetic results because of residual perilesionalvascularization and some associated interface haze.1 caseswhich had preoperative vascularization around huge lesionhad only moderate cosmetic result and opaque graft as a resultof rejection.3.vision19 patients has the visual acuity outcomes. Afteramblyopia treatment ,the visual acuity of 15 patients showedno improvement,4 patients showed a little improvement.4.complicationsa. rejection1 patient which had many vascular in or around hugelesion preoperatively occurred rejection 2 months after theoperation. The episode subsided after intensive antirejectionmedications and removed the loose sutures,with opaque graftleft.b. perforation of corneal bed1 patient with deep lesion had his corneal bed perforatedduring the operation.This may be caused by the wrong using ofthe beaber blade direction.The perforation wound was suturedwith 10-0 nylon interrupted suture.c. interface blood2 of our patients had interface blood. A bandage wastake-up on the operated eye and according medicine wasgiven.The blood was absorbed 2 months later。Consequently,we believe lamellar keratoplasty was abetter choice because it offers excellent appearance andtectonic stability.Furthermore ,the lesion should be operatedwhen it was small and superficial to has a good result.