The Surgical Outcomes of Simple Keratectomy for Limbal Dermoids

Chang Ki Yoon; Jeong Hun Kim; Seong Joon Kim; Young Suk Yu

doi:10.3341/jkos.2008.49.6.897

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Yoon, Kim, Kim, and Yu: The Surgical Outcomes of Simple Keratectomy for Limbal Dermoids

Original Article

J Korean Ophthalmol Soc 2008;49(6):897-903.

Published online: 8 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.6.897

The Surgical Outcomes of Simple Keratectomy for Limbal Dermoids

Chang Ki Yoon, M.D.¹, Jeong Hun Kim, M.D.^1,², Seong Joon Kim, M.D.^1,², Young Suk Yu, M.D.^1,^2,

¹Department of Ophthalmology, Seoul National University College of Medicine Seoul, Korea

²Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute Seoul, Korea

Address reprint requests to Young Suk Yu, M.D. Department of Ophthalmology, Seoul National University Hospital #28 Yongon-dong, Chonno-gu, Seoul 110-744, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: ysyu @snu.ac.kr

13 February 2008 Accepted 28 September 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the results of simple keratectomy for limbal dermoids.

Methods

We reviewed the ocular records of 29 consecutive patients with limbal dermoids who had undergone simple keratectomy in Seoul National University Children’s hospital from 1989 to 2006. The preoperative and postoperative visual acuity and astigmatism levels as well as the cosmetic outcomes were measured.

Results

The mean age at surgery was 28 months (range, 6~70 months), and the mean follow-up period was 56 months (range, 18~168 months). The mean visual acuity at the last follow-up was 20/30. The mean preoperative and postoperative cylinder was -2.64D and -2.12D, respectively, in the affected eye ( p=0.064); and -0.79D and -0.43D, respectively, in the fellow eye ( p=0.149). There was a significant correlation between preoperative astigmatism and the final visual acuity in the involved eye. No opaque lesions were visible at a distance of 1 meter in 16 of the 29 eyes (55.2%), and there were no significant complications related to the surgery.

Conclusions

Simple keratectomy of limbal dermoids can be a good surgical technique to get a cosmetically acceptable corneal clarity without complication.

Keywords: Astigmatism, Corneal clarity, Limbal dermoids, Simple keratectomy

References

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Figure 1.

Corneal opacity grade after surgery. (A) Grade 1 opacity (invisible opacity at 1 meter), (B) Grade 2 opacity (visible opacity at 1 meter), (C) Grade 3 opacity (invasion into visual axis), (D) Grade 4 opacity (pseudopterygium or fibrovascular scar), (E) Photo of patient B taken before operation.

Figure 2.

Best corrected visual acuity change after surgery in affected eye Postoperative visual acuity increased in all of 6 patients. (All dots are located below the diagonal line.)

Figure 3.

Difference of the angle between minus cylinder axis and the lesion.

Figure 4.

Cosmetic outcome

Figure 5.

Correlation between final visual acuity and preoperative cylinder.

Table 1.

Visual acuity change after surgery (Postoperative data was obtained from all patients)

	Preop BCVA^*	Postop BCVA	P^{^‡}
Affected eye	0.21±0.17	0.42±0.56	0.623
Fellow eye	0.22±0.20	0.07±0.13	0.062
P^{^†}	0.844	0.000^§

^* Best corrected visual acuity (logMAR)

^† Wilcoxon signed rank test

^‡ Mann-Whitney U test

^§ P<0.05.

Table 2.

Visual acuity change after surgery (In 6 patients who had the preoperative visual acuity checked)

	Preop BCVA^*	Postop BCVA	P^†
Affected eye	0.21±0.17	0.00±0.20	0.027^‡
Fellow eye	0.22±0.20	-0.01±0.06	0.043^‡
P^†	0.752	1.000

^* Best corrected visual acuity (logMAR);

^† Wilcoxon signed rank test

^‡ P<0.05.

Table 3.

Refractive error change after surgery (In 16 patients who had both preoperative and postoperative refraction)

	Preop (D)	Postop (D)	P^*
SE^† in affected eye	0.80±3.270	-0.21±2.27	0.055
SE^† in fellow eye	0.57±1.195	-0.71±1.37	0.009^‡
P^*	0.365	0.127
Astigmatism in affected eye	-2.64±1.86	-2.12±1.86	0.064
Astigmatism in fellow eye	-0.79±0.99	-0.43±0.65	0.149
P^*	0.002^‡	0.004^‡

^* Wilcoxon signed rank test

^† Spherical equivalent

^‡ P<0.05.

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