Surgical management of large bilateral epibulbar dermoids with autologous oral mucous membrane transplantation

Abstract

Purpose: To report the surgical management of extensive epibulbar dermoids with autologous oral mucous membrane transplantation.

Observations: While rare, extensive dermoids that encroach upon the visual axis carry a poor prognosis. We report the case of a 7-week old premature male infant who presented with large bilateral epibulbar dermoids obscuring the visual axis. He was treated first with sequential bilateral optical iridectomies under the clearest corneal areas, followed several months later by sequential dermoid excision and amniotic membrane transplantation in each eye. He subsequently underwent autologous "simple" oral mucosal epithelial transplantation (SOMET) as well as strabismus surgery. Conclusions and Importance: Here we present the first case, to the best of our knowledge, of the use of SOMET in managing post-operative pseudopterygium following dermoid excision. To our knowledge it is the also the first application of this technique in a young pediatric patient. A good clinical outcome may be achieved with SOMET, which may offer a minimally invasive alternative to other traditional modalities.

Keywords: Amniotic membrane transplantation; Epibulbar dermoid; Limbal dermoid; Limbal stem cell deficiency; Ocular surface reconstruction.