[Epibulbar dermoids--clinical features and therapeutic methods].

BACKGROUND

In a strict sense epibulbar dermoids are defined as congenital changes of mesodermal and ectodermal origin. Usually they are located at the limbus of the cornea in the inferotemporal quadrant, they can only rarely be observed in more central regions of the cornea. Intraocular structures are rarely involved. Connections to Goldenhar's oculo-auriculo-syndrome exist. Because of cosmetic reasons or a considerable astigmatism holding the danger of amblyopia a resection might be necessary.

PATIENTS AND METHODS

Six patients (three girls and three boys) aged from 9 months to 6 years with limbal dermoids were included in the present study. All patients had been referred to the University Eye Hospital of Dresden for a possible therapy.

RESULTS

All children showed a unilateral dermoid in the inferotemporal quadrant. In five cases the left eye was affected. In two patients a Goldenhar syndrome was present. In two patients a local resection of the dermoid was indicated. In three patients a keratoplasty (two lamellar, one penetrating) was additionally carried out. In the case of a two-year-old girl only prophylactic treatment of amblyopia was considered. The postoperative results reached from uncomplicated healing (visual acuity 1.0) to full cloudiness of the transplant and re-keratoplasty (visual acuity lux).

CONCLUSION

Controls of the dermoid in half-year intervals and surgical intervention in early childhood are recommended. Simple local resection or a combination with lamellar or penetrating (sclero)-keratoplasty are used. A penetrating keratoplasty is seldom necessary due to deep and central dermoids. The prognosis can be described as favourable.