Long-Term Clarity of Tectonic Lamellar Keratoplasty for Limbal Dermoids

To investigate the long-term outcome of surgical intervention for limbal dermoids and to evaluate the safety and efficacy of tectonic lamellar keratoplasty.

This retrospective cohort study included 86 eyes that underwent tectonic lamellar keratoplasty by 5 corneal surgeons at Kyoto Prefectural University of Medicine and Baptist Eye Institute, Kyoto, Japan, from 1992 through 2024. The study subjects were categorized into 2 groups: group A, consisting of 35 eyes that underwent amblyopia treatment, and group B, consisting of 51 eyes that did not.

Kaplan-Meier survival analysis revealed 95.3% (82 of 86 eyes) maintained clear tectonic corneal grafts with healthy ocular surfaces postoperatively. Three eyes developed psudopterygium formation, and 1 eye developed a corneal infection. Improvement of 0.2 logarithm of the minimum angle of resolution units or more because of preoperative amblyopia treatment was observed in 48.6% (17 of 35 eyes) in group A. Surgical intervention resulted in an improvement of 0.2 logarithm of the minimum angle of resolution units or more in 25.7% (9 of 35 eyes) in group A, and 15.7% (8 of 51 eyes) in group B. One case of corneal infection resulted in decreased best-corrected visual acuity. No other cases exhibited best-corrected visual acuity deterioration.

Tectonic lamellar keratoplasty can be performed safely with very few postoperative complications, maintaining long-term corneal clarity, reasonable visual acuity, and satisfactory cosmetic results.