Fibrin-glue assisted multilayered amniotic membrane transplantation in surgical management of pediatric corneal limbal dermoid: a novel approach

Abstract

PurposeTo report a new surgical technique for excising pediatric corneal limbal dermoid and the post-resection ocular surface reconstruction.MethodsWe describe a method of deep lamellar excision followed by sutureless multilayered amniotic membrane transplantation in surgical management of corneal limbal dermoid.ResultThis technique achieves a rapid corneal re-epithelization, reduces post-operative pain, and will diminish post-operative scarring. Preoperative corneal astigmatism will persist.ConclusionThis method offers an alternative surgical approach in comparison to simple excision in removal of simple pediatric corneal limbal dermoids.

Surgical management of corneal limbal dermoids: retrospective study of different techniques and use of Mitomycin C

“…The poor outcome of amniotic membrane transplantation in our study stands in contrast to the previous reports. 10,12,13 All eyes treated with Mitomycin C, however, showed no development of a pseudopterygium during the follow-up. Therefore, a beneficial effect of Mitomycin C on postoperative pseudopterygium formation has to be considered likely.…”

“…[1][2][3][4][5][6][7] The use of amniotic membrane transplantation in the removal of a limbal dermoid has recently been described by others. 10,12,13 The main reasons for using amniotic membrane transplantation on conjunctival defects are the positive effects on reepithelialization and inhibition of postoperative inflammation, neovascularisation, and fibrosis. 17 Pirouzian et al 11 reported that the purpose of amniotic membrane transplantation was primarily to achieve a volumetric filling of the stromal and epithelial defect after the removal of a limbal dermoid.…”

“…Reduced inflammation with consecutive protection of the limbal stem cells is another commonly assumed mechanism of action. 11,12 A removal of a limbal dermoid alone can lead to a limbal stem cell deficiency and pseudopterygium formation. 18 Therefore, stem cell transplantation may be a more beneficial approach.…”

“…[10][11][12] The fibrin-glued multilayered amniotic membrane transplantation was discussed to improve postoperative reepithelialization, prevent post-operative scarring, and protect the limbal stem cells. 11,12 (2) The use of Mitomycin C: Mitomycin C as an antitumor antibiotic was first isolated from Streptomyces caespitosus in 1958. 13 It is used in pterygium surgery since 1963 in order to reduce the recurrence rates.…”

Amniotic Membrane Grafts in Pediatric Corneal Limbal Dermoids with Conjunctival Eyelashes: A Case Presentation

“…There are many different opinions about the optimal method and appropriate time for removal of these tumors [5]. Obtaining a thorough history, serial monitoring of the dermoid during office visits using cycloplegic retinoscope to measure the dermoid's size, assessment for change in amblyopia, and the use of ultrasound biomicroscopy to assess the involvement of Descemet's membrane play a big role in the choice of what surgical technique to use [9]- [11]. Authors have found optical coherence tomography (OCT) helpful in determining the depth of the dermoid involvement in cornea.…”