Visual and surgical outcomes of limbal dermoid excision at a tertiary care eye hospital.

PURPOSE: To evaluate the presenting complaints, surgical management, surgical outcomes, complications, and postoperative visual acuity following limbal dermoid excision.

DESIGN: Retrospective cohort study.

METHODS: Medical records of patients with limbal dermoid presenting between January 2012 and December 2020 were retrieved to extract data regarding demographics, presenting profiles including the best-corrected visual acuity (BCVA), symptoms, anterior segment examination, and refraction. The outcomes included cosmesis, complications, graft transparency, and BCVA at the last follow-up.

RESULTS: Fifty-one eyes from 50 patients (27 males) were evaluated. The median age at the time of surgery was 11.5 years (interquartile range, IQR: 0.0-45.7). The median follow-up time was 5 years (IQR: 4-6). Goldenhar syndrome was noted in 5 patients (10%). The indications for surgery were cosmetic concerns (n  =  20, 39%), anisometropia (n  =  3, 6%), decreased vision (n  =  4, 8%), and growth or Dellen formation (n  =  2, 4%). Forty-eight were operated upon, opting for simple excision (n  =  12, 23.5%), amniotic membrane transplantation (n  =  16, 31.4%), lamellar keratoplasty (n  =  15, 29.4%), and penetrating keratoplasty (n  =  5, 9.8%). The most common complications were corneal scarring (n  =  19, 37.2%), corneal vascularization (n  =  2, 3.9%), and infection (n  =  1, 2%). Astigmatism > 1 D was observed in 34 (66.7%) eyes after dermoid management ( p  < 0.001). There were no complications in 14 eyes (27%), BCVA was > 20/60 in 43 eyes (84.3%), and only two eyes had BCVA < 20/400.

CONCLUSION: Surgical management of limbal dermoids offers promising functional and anatomic outcomes. However, postoperative astigmatism may require further follow-up and management.