The Surgical Outcomes of Simple Keratectomy for Limbal Dermoids

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.

Combined Keratoplasty and Cataract Surgery

We evaluated the clinical results of the combined keratoplasty and cataract surgery. Fifty nine patients were devided into 3 groups according to the operation type: Group I; penetrating keratoplasty, cataract extraction and intraocular lens implantation (triple procedure), Group II; penetrating keratoplasty and cataract extraction, Group III; penetrating keratoplasty and intraocular lens implantation. The most common cause of corneal opacity was infection in group I and II, and aphakic bullous keratopathy in group III. The preoperative best corrected visual acuity was less than 20/200 in almost all patients. The postoperative corrected visual acuity of 20/100 or better was obtained in 70%(14 eyes), 53%(9 eyes) and 33.3%(5 eyes) in group I, II and III and 12 months. Clarity of the graft cornea was maintained 90.9% in group I, 55% in group, and 64.7% in group III. The two most common complication were graft rejection and glaucoma. From above results, combined keratoplasty and cataract surgery could be an available procedure which obtain a good visual outcome in patients who have both corneal opacity and cataract. Especially, the triple procedure offers patients the chance of an early visual rehabilitation after graft and cataract surgery with a little risk of complication. However, more careful preoperative examinations and postoperative managements should be necessary for a higher success-rate.