Preoperative geometric parameters predict the outcome of lamellar keratoscleroplasty in patients with limbal dermoids

• Published in: International ophthalmology Vol. 43; no. 7; pp. 2273 - 2282
• Main Authors: Lin, Yongdong, Xie, Jihui, Wang, Hongxi, Lu, Jiamin, Ma, Di
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.07.2023; Springer Nature B.V
• Subjects: Acuity; Astigmatism; Coefficients; Cornea; Intraocular pressure; Lamellar structure; Medicine; Medicine & Public Health; Ophthalmology; Original Paper; Parameters; Patients; Regression analysis; Visual acuity; Visual aspects; Geometric parameter; Lamellar keratoscleroplasty; Corneal limbal dermoid; Amblyopia; Astigmatism
• ISSN: 1573-2630; 0165-5701; 1573-2630
• DOI: 10.1007/s10792-022-02623-9

Purpose To find preoperative simple geometric parameters to predict the outcome of lamellar keratoscleroplasty in patients with corneal limbal dermoids. Methods We retrospectively analyzed the data of 30 patients with limbal dermoids who underwent lamellar keratoscleroplasty and were followed up for more than 6 months. Seven geometric parameters were used to analyze the relationship with postoperative visual acuity, astigmatism, and scar formation and investigated for their influence on postoperative outcome. These seven parameters included the cornea-invaded area of dermoid, dermoid area, the cornea-invaded length of dermoid, the corneal limbus invaded length of dermoid, dermoid size, bed size, graft size. Furthermore, we divided patients with corneal limbal dermoids into amblyopia group and non-amblyopia group, and analyzed the clinical characteristics of the amblyopia group. Results The mean age of the patients at surgery was 10.6 ± 5.83 years. The 7 geometric parameters, preoperative and postoperative astigmatism of the amblyopia group were higher than those of the non-amblyopia group (all P  < 0.05). Among the geometric parameters analyzed, the r coefficients between the cornea-invaded length of dermoid and postoperative visual acuity and astigmatism were the highest ( r  = 0.854, r  = 0.714). The r coefficient between the corneal limbus invaded length of dermoid and the postoperative scar was the highest ( r  = 0.375). The r coefficient between age and postoperative steroid-induced high intraocular pressure was the highest ( r  = − 0.416). In univariate regression analysis, the cornea-invaded length of dermoid was significantly correlated with postoperative visual acuity ( β  = 0.270, P  < 0.001) and postoperative astigmatism ( β  = 1.362, P  < 0.001). Among the geometric parameters analyzed, the cornea-invaded length of dermoid had best stratified patients in grouping with or without amblyopia (cutoff > 2.24). Conclusion The cornea-invaded length of dermoid was the most important related factor of postoperative visual acuity, astigmatism, and amblyopia. The corneal limbus invaded length of dermoid was the most important related factor of postoperative scar formation. The geometric parameters and astigmatism in patients with amblyopia were larger than those in patients without amblyopia.