title: Preoperative evaluation and outcome of corneal transplantation for limbal dermoids: a ten-year follow-up study.
abstract: OBJECTIVE
  To summarize preoperative evaluation and outcome of corneal transplantation for limbal dermoids for ten years.
  
  
  METHODS
  Eighty-five patients diagnosed with limbal dermoids and treated with corneal transplantation were analyzed retrospectively. All patients were further divided into two groups according to absence or presence of neovascularization surrounding the dermoids in the corneal stroma. Eighty-two eyes were treated with tumor excision combined with partial lamellar sclerokeratoplasty, and the other three eyes were performed by penetrating keratoplasty. The size and location of the tumor, the associated ocular and systemic anomalies, the depth of the corneal penetration of tumor tissues, the preoperative and postoperative best-corrected visual acuity (BCVA), graft survival and cosmetic outcome, and surgical complications were recorded respectively.
  
  
  RESULTS
  The average age at surgery was 5.3y (range, 3mo-36y). The mean size of dermoids was 6.1±1.6 mm. The 43.5% of eyes (37/85) were present with hair at the surface of the dermoid and 72.9% of dermoids were located inferotemporal of the eye. Amplyopia was present in 34.1% of patients (29/85) and 9.4% of patients (8/85) had lipodermoids. Eighteen patients suffered from Goldenhar's syndrome with an accessory ear. The 75% of patients in group 1 had involvement of the corneal deep stroma down to Descemet's membrane without involving it, but 71.4% of patients had Descemet's membrane involvement in group 2. Preoperative BCVA ranged from counting fingers to 20/20. Postoperatively 81.1% had a BCVA of 20/800 or better. There was no significant difference between the post-surgical BCVA of the two groups (t=1.584,P>0.05). The grafts of 70.5% patients were present as 1+ opacity, 21.1% as 2+ opacity, 8.2% as 3+ opacity and none as 4+ opacity. Surgical complications included graft rejection, microperforation, prolonged reepithelialization, steroid glaucoma, interface neovascularization, and interface hemorrhage.
  
  
  CONCLUSIONS
  The dermoids with neovascularization surrounding them in the corneal stroma invaded deeper tissues in the cornea than those with no neovascularization surrounding them in the corneal stroma. Therefore, surgeons should take care to avoid corneal perforation during the corneal transplantation operation. The majority of patients markedly improved their cosmetic appearance after surgery.
authors.affiliation: Shandong University, Jinan 250012, Shandong Province, China; Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Xin
authors.affiliation: Department of Ophthalmology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China.
authors.forename: Yue-Rong
authors.initials: YR
authors.lastname: Gong
authors.affiliation: Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China.
authors.forename: Shan-Hao
authors.initials: SH
authors.lastname: Jiang
authors.affiliation: Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Dai
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China.
authors.forename: Su-Xia
authors.initials: SX
authors.lastname: Li
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China.
authors.forename: Wei-Yun
authors.initials: WY
authors.lastname: Shi
keywords: corneal transplantation; limbal dermoids; neovascularization