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DR Wolff, GW Zaidman, M Hoehn, N Medow, E BennettPediatric Keratoplasty Association; Long-Term Follow-up of Children after Excision of Corneal Dermoid . Invest. Ophthalmol. Vis. Sci. 2002;43(13):143.
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Purpose: To report long-term follow-up of astigmatism and vision in children with excised corneal dermoids. Methods: Eight children with corneal dermoids ages 9 months to 15 years were assessed before and after excision by retinoscopy, topographic videokeratoscopy or keratometry. Pre and post excision astigmatism and visual acuity were compared. Student’s t-test was used. All patients were treated with dermoid excision and lamellar patch keratoplasty grafts. Results: Astigmatism was reduced after excision in five out of seven patients. Pre-excision mean keratometry was 4.8 ± 3.1 (range 0 - 7.86) diopters and postoperatively was 2.6 ± 1.6 (range 0 to 4.75 diopters) (p<.03). In two patients astigmatism increased postoperatively but by less than 1.25 diopters. Two patients had progressive astigmatism before surgery that increased from 2.0 diopters to 7.0 diopters. Preoperative best corrected mean visual acuity in the involved eye was 20/45 (range 20/25 - 20/80) and slightly improved postoperatively (mean 20/39) (p<0.09). Five children had amblyopia of greater than two lines on the Snellen chart at last follow-up. No patient had complications from excision and all had improved cosmesis. Postoperative follow-up time was 3-120 months. Conclusion: Some corneal dermoids are associated with high astigmatism which can be progressive and amblyogenic. Excision of childhood corneal dermoids should be considered to improve cosmesis, reduce astigmatism and lessen the risks of amblyopia.
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