Scott J A, Tan D T
Singapore National Eye Centre, Singapore.
Ophthalmology. 2001 Oct;108(10):1858-67. doi: 10.1016/s0161-6420(01)00705-9.
To assess the surgical outcomes of appearance, vision, refraction, and graft survival and integrity in patients with histologically proven limbal dermoid choristomata who underwent lamellar keratoplasty.
Retrospective noncomparative analysis of a consecutive case series with patient recall and examination.
Eleven patients (six female, five male, median age, 9.6 years; range, 1-29 years) with 12 limbal dermoids in 11 eyes operated on between 1995 and 1998 were identified from the eye bank database at the Singapore National Eye Centre.
Case records, photographs, and eye bank data were examined. Patients not already seen by the authors within the previous 3 months were recalled and examined.
Descriptive data: size and location of the dermoid, presence of lipid keratopathy; visual acuity; refraction and astigmatism, vector analysis, surgically induced refractive change; corneoscleral and limbal match, haze, vascularity; graft integrity, clarity, vascularization, and rejection episodes.
Most (7 of 11) patients had single inferotemporal limbal dermoids, although one patient had two dermoids in one eye. Median follow-up time was 21.6 months (range, 9.0-46.4 months). Most (8 of 11) patients had good or excellent cosmetic results with minimal interface haze and no vascularization. Two cases with previously excised lesions had postoperative vascularization develop. One of these cases had graft infection develop, underwent subsequent debridement, and has an opaque graft. Best-corrected visual acuity was maintained or slightly improved in 9 of 11 patients. For the group and most individual patients, mean astigmatism, spherical equivalent, and refraction, as assessed by surgically induced refractive change and h-vector analysis, were not significantly changed.
Lamellar keratoplasty as primary surgery for limbal dermoids gave good cosmetic results. However, improvement in refractive, astigmatic, and visual status is not guaranteed, and these procedures should be viewed more cautiously, although established good vision was maintained in our series.
评估经组织学证实为角膜缘皮样瘤错构瘤且接受板层角膜移植术患者的外观、视力、屈光及植片存活和完整性方面的手术效果。
对一系列连续病例进行回顾性非对照分析，并对患者进行回访和检查。
从新加坡国立眼科中心眼库数据库中识别出1995年至1998年间接受手术的11例患者（6例女性，5例男性，中位年龄9.6岁；范围1 - 29岁），其11只眼中有12个角膜缘皮样瘤。
检查病例记录、照片和眼库数据。召回并检查在过去3个月内未被作者诊治过的患者。
描述性数据：皮样瘤的大小和位置、脂质角膜病变的存在情况；视力；屈光和散光、矢量分析、手术引起的屈光变化；角膜巩膜和角膜缘匹配情况、 haze、血管化程度；植片完整性、清晰度、血管化情况及排斥反应。
大多数（11例中的7例）患者有单个颞下象限角膜缘皮样瘤，尽管1例患者一只眼中有两个皮样瘤。中位随访时间为21.6个月（范围9.0 - 46.4个月）。大多数（11例中的8例）患者获得了良好或极佳的美容效果，界面haze极少且无血管化。2例既往有病变切除史的病例术后出现血管化。其中1例发生植片感染，随后进行了清创，植片不透明。11例患者中有9例的最佳矫正视力得以维持或略有提高。通过手术引起的屈光变化和h矢量分析评估，该组及大多数个体患者的平均散光、球镜等效度和屈光均无显著变化。
板层角膜移植术作为角膜缘皮样瘤的初次手术可获得良好的美容效果。然而，屈光、散光和视力状况的改善并无保证，尽管在我们的系列研究中已确立的良好视力得以维持，但这些手术仍应更谨慎地看待。
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