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Purpose : To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) for limbal dermoids at Vietnam National Institute of Ophthalmology (VNIO).
Methods : A retrospective study was done on 23 eyes (23 patients) undergoing DALK of limbal dermoids from 2013 – 2017 at VNIO. The manual DALK was done with the graft from anterior flap of pre-cut cornea used for DSAEK. The patients' demography, best-corrected visual acuity (BCVA), cosmetic outcomes, and surgical complications were measured as outcome indicators.
Results : The average age at surgery was 5,11 years (range, 8 months - 19 years) with 13 males and 10 females. Most (20 of 23) patients had infero-temporal limbal dermoids. Fourteen patients suffered from Goldenhar’s syndome with an accessory ear. The mean size of dermoids was 6,02 ± 1,16 mm (range, 4 – 9 mm). All of patients had good cosmetic results. The grafts were clear and had no vascularization in 8/23 (34,8%) eyes. Mild haze grafts with minimal vascularization were found in 10/23 (43.5%) eyes, moderate haze graft and vascularization in 3/23 (13%) eyes. Two eyes (8,7%) had opaque graft with deep vascularization. All patient were satisfy with surgical outcome. The visual acuity was unchanged in almost patients due to amplyopia. There were no recurrent cases. Surgical complications included prolonged reepithelialization, interface neovascularization.
Conclusion : DALK with anterior flap from precut cornea was a safe and effective surgery to treat limbal dermoids. The cosmetic results was good with no change in the vision
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