Visual and surgical outcomes of limbal dermoid excision at a tertiary care eye hospital

Purpose To evaluate the presenting complaints, surgical management, surgical outcomes, complications, and postoperative visual acuity following limbal dermoid excision. Design Retrospective cohort study. Methods Medical records of patients with limbal dermoid presenting between January 2012 and December 2020 were retrieved to extract data regarding demographics, presenting profiles including the best-corrected visual acuity (BCVA), symptoms, anterior segment examination, and refraction. The outcomes included cosmesis, complications, graft transparency, and BCVA at the last follow-up. Results Fifty-one eyes from 50 patients (27 males) were evaluated. The median age at the time of surgery was 11.5 years (interquartile range, IQR: 0.0-45.7). The median follow-up time was 5 years (IQR: 4-6). Goldenhar syndrome was noted in 5 patients (10%). The indications for surgery were cosmetic concerns (n = 20, 39%), anisometropia (n = 3, 6%), decreased vision (n = 4, 8%), and growth or Dellen formation (n = 2, 4%). Forty-eight were operated upon, opting for simple excision (n = 12, 23.5%), amniotic membrane transplantation (n = 16, 31.4%), lamellar keratoplasty (n = 15, 29.4%), and penetrating keratoplasty (n = 5, 9.8%). The most common complications were corneal scarring (n = 19, 37.2%), corneal vascularization (n = 2, 3.9%), and infection (n = 1, 2%). Astigmatism > 1 D was observed in 34 (66.7%) eyes after dermoid management (p < 0.001). There were no complications in 14 eyes (27%), BCVA was > 20/60 in 43 eyes (84.3%), and only two eyes had BCVA < 20/400. Conclusion Surgical management of limbal dermoids offers promising functional and anatomic outcomes. However, postoperative astigmatism may require further follow-up and management.