ABSTRACT
PURPOSE: To further evaluate the efficacy of a new surgical technique for removal of pediatric corneal-limbal dermoids and ocular surface reconstruction using multilayered amniotic membrane. METHODS: Three pediatric patients with corneal-limbal dermoid (grade I) in one practice were identified in a retrospective fashion. All patients underwent deep lamellar excision followed by sutureless multilayered amniotic membrane transplantation by a single surgeon (AP). Preoperative and postoperative visual acuity, anterior segment examination, anterior segment B-scan, and cycloplegic refraction were performed. RESULTS: Three patients with ages ranging from 6 months to 18 years had a postoperative follow-up of 9 to 12 months from the time of surgery. This surgical technique achieved rapid postoperative corneal re-epithelialization, reduced postoperative pain, and diminished postoperative scarring in all three patients. Existing preoperative astigmatism remained unchanged throughout the follow-up period. No intraoperative or postoperative complications were noted. CONCLUSION: This surgical approach offers an alternative surgical technique to a simple excision with or without deep lamellar keratoplasty for removal of pediatric corneal-limbal dermoids (grade I). In the management of pediatric limbal dermoids (grade I), surgical excision combined with sutureless multilayered amniotic membrane transplantation eliminates painful postoperative recovery and corneal neovascularization, and can achieve an improved long-term ocular surface cosmesis.
Subject(s)
Amnion/transplantation , Corneal Diseases/surgery , Dermoid Cyst/surgery , Limbus Corneae/surgery , Ophthalmologic Surgical Procedures , Adolescent , Corneal Diseases/pathology , Dermoid Cyst/pathology , Epithelium, Corneal/physiology , Female , Follow-Up Studies , Humans , Infant , Limbus Corneae/pathology , Male , Plastic Surgery Procedures , Suture TechniquesABSTRACT
PURPOSE: To report a new surgical technique for excising pediatric corneal limbal dermoid and the post-resection ocular surface reconstruction. METHODS: We describe a method of deep lamellar excision followed by sutureless multilayered amniotic membrane transplantation in surgical management of corneal limbal dermoid. RESULT: This technique achieves a rapid corneal re-epithelization, reduces post-operative pain, and will diminish post-operative scarring. Preoperative corneal astigmatism will persist. CONCLUSION: This method offers an alternative surgical approach in comparison to simple excision in removal of simple pediatric corneal limbal dermoids.
Subject(s)
Amnion/transplantation , Fibrin Tissue Adhesive/therapeutic use , Limbus Corneae/surgery , Ophthalmologic Surgical Procedures , Tissue Adhesives/therapeutic use , Choristoma/surgery , Corneal Diseases/surgery , Growth Disorders/surgery , Humans , Infant , Male , Pain, Postoperative/prevention & control , Plastic Surgery ProceduresABSTRACT
Horner syndrome, a triad of ptosis, anisocoria, and anhidrosis, results from interruption in the oculosympathetic pathway. It is classically described as either congenital or acquired to depict its underlying pathophysiology and requisite work-up. We report a case of a 10-month-old infant presenting with an acute onset of left Horner syndrome secondary to a spontaneous extracranial internal carotid artery dissection. To the best of our knowledge, this is the first case report in the literature of acute onset of acquired infantile Horner syndrome in association with spontaneous carotid artery dissection confirmed with magnetic resonance angiogram.
