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The authors aimed to report the visual and refractive outcomes and complications of simple excision of limbal dermoid (LD) sparing the visual axis and Descemet’s membrane in children aged ≤8 years. This was a retrospective review over 2000-2019 including 19 children: eight female and eight involving the right eye. Mean age was 4.2 ±2.0 years (0.75-8 years). Preauricular tags and / or Goldenhars syndrome were noted in seven of 19 children (37%). One child had extensive bilateral LD. One had a large upper eyelid coloboma. Mean follow-up was four ±4 years (one month to two years). Surgery indications included cosmesis (six), amblyopia (six), discomfort (three), astigmatism, (three) and not specified (one). Where possible to measure, visual acuity was 0.30 ±0.27 logMAR pre and 0.31 ±0.53 postoperative (not significant). The average astigmatism was 3.20 ±1.80D pre and 3.50 ±2.20D postoperative, again not significant. Astigmatic axis changed by a mean -7 ±26 degrees. Postoperative corneal epithelial defects healed in a mean time of eight days. All had good cosmetic outcomes. There were no corneal perforations. One patient had a residual dermoid tissue close to the limbus but this was not cosmetically obvious and required no further excision. There were no cases of pseudo pterygium. Eleven of 19 children had amblyopia and received usual treatment. The authors conclude simple excision in young children is safe and effective with grade I or II LD sparing the visual axis and with good cosmetic outcomes.

Management of limbal dermoid by simple excision in young children.
Promelle V, Lyons CJ.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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