Surgical Management of Limbal Dermoids Using Anterior Corneal Buttons From Descemet Stripping Automated Endothelial Keratoplasty Donor Tissue as Patch Grafts.
OBJECTIVE
To assess the surgical and clinical outcomes of anterior lamellar keratoplasty using anterior corneal buttons from Descemet stripping automated endothelial keratoplasty (DSAEK) donor tissue.


METHODS
Retrospective data from 8 patients with unilateral limbal dermoids, treated between February 2011 and January 2016 at National Taiwan University Hospital, were analyzed. Donor corneas for DSAEK were divided into anterior and posterior lamellae using a 350-μm microkeratome. Anterior corneal buttons were stored for up to 4 weeks in storage media before being used as patch grafts for anterior lamellar keratoplasty.


RESULTS
Corneoscleral integrity was preserved in all cases. Three of the 8 patients showed improved best-corrected visual acuity after surgery. Three patients' astigmatism reduced by more than 0.75 diopters. All 8 patients had satisfactory cosmesis after surgery. Neovascularization at the graft-host junction and graft edema was noted in 1 patient and was treated using bevacizumab injection and topical steroid.


CONCLUSIONS
Anterior corneal buttons obtained from DSAEK can be used as patch grafts for surgical management of limbal dermoids. This procedure achieved satisfactory cosmetic and visual outcomes in our study. This procedure may potentially allow one corneal tissue to be received by multiple patients.
*Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; †Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan; ‡Sydney Medical School, University of Sydney, Sydney, Australia; and §Center of Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan.
Kuan-I
KI
Wu
Hsiao-Sang
HS
Chu
Amy Shih-I
AS
Pai
Yu-Chih
YC
Hou
Szu-Yuan
SY
Lin
Wei-Li
WL
Chen
Fung-Rong
FR
Hu
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000601:surgery*; D003884:Dermoid Cyst / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005134:Eye Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods; D014792:Visual Acuity; D055815:Young Adult