Presentation and Surgical Management of Epibulbar (Limbal) Dermoids

Abstract

Purpose: To report clinical characteristics and surgical outcomes of limbal dermoids excision in Pakistani patients.

Study Design: Retrospective, Descriptive.

Place and Duration of Study: Mughal Eye Hospital Lahore from 1^st June 2016 to 30 Dec 2017.

Material and Methods: Records of 15 epibulbar dermoids were reviewed. Site, colour, presence of pigmentation and presence of ocular and systemic associations of the lesions were studied. Lesions were photographed and then surgically managed. Excision was done with blade and scissors. Postoperative follow up included management of complications and photograph on each visit.

Results: Age ranged from 4 to 60 years (Mean 18 ± 13.48). Male to female ratio was 6:9. All the patients had unilateral epibulbar dermoids, which were present in inferotemporal quadrant of the limbus. Most lesions (9 cases - 60%) involved cornea and sclera equally while a few extended more on the scleral (3 cases - 20%) or corneal side (3 cases - 20%). Most (12 cases - 80%) were round and a few (3 cases- 20%) tapering. 5 (33%) had Goldenhar Syndrome. 4 (27%) patients had preauricular tags. One (7%) patient had maxillary hypoplasia and divergent squint. Postoperatively one patient (7%) had corneal thinning and one patient (7%) had extensive formation of granulation tissue. There was pigmentation of the lesion in 12 cases (80%). Three (20%) patients had microtia.

Conclusion: Limbal dermoids in Pakistani patients have characteristics resembling those described in other parts of the world. Treatment with excision and superficial sclerokeratectomy without graft gives satisfactory results.

Keywords: Epibulbar Dermoids, Limbal Dermoids, Goldenhar syndrome.