Limbal Dermoid Treatment & Management

Updated: Sep 25, 2018
  • Author: Mark D Sherman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Approach Considerations

A three-tiered classification system based on anatomic features has been used to guide management planning. [2]

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Surgical Care

Treatment of limbal dermoids may consist of periodic removal of irritating cilia, topical lubrication to prevent foreign body sensation, or excision of the lesion if it is causing significant cosmetic disfigurement or interfering with vision.

Surgical treatment should be instituted only when the risk of subsequent scar formation or surgical complications are outweighed by the likelihood of improving the patient's vision or cosmetic appearance.

A superficial sclerokeratectomy, cutting flush with the surface of the globe, is the procedure of choice for removal of the dermoid. Excised tissue always should be sent to the pathologist for examination.

Attempts at complete removal are unnecessary. The lesion may extend into the deeper structures of the eye and the risk of perforation increases if attempts are made to remove the lesion completely.

The exposed sclera should be covered by relaxing the adjacent conjunctiva and sewing it into the scleral defect. If a deep excision is necessary, then a lamellar keratoplasty can be performed to reinforce the site of excision.

Large patches of bare sclera can be treated with application of single or multilayered amniotic membrane graft tissue. The amniotic membrane can be secured to underlying sclera using sutures and/or fibrin-glue adhesive. [10]

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Consultations

Obtaining a thorough family and medical history helps determine whether further consultation is necessary.

In some cases, referral to a pediatrician with specialization in genetics is appropriate.

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