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Combining Corneal Neurotization With Limbal Dermoid Excision: Case Report and Literature Review
Pareena Sharma1,2, Khoa Tran2, Charline S Boente1
1Departments of Ophthalmology.
Journal of Pediatric Ophthalmology and Strabismus
|July 21, 2026
Summary
This study presents a novel combined surgical approach for a child with VACTERL-associated eye conditions. Corneal neurotization alongside dermoid excision successfully restored corneal sensation and improved ocular surface health.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Pediatric Surgery
Background:
- VACTERL (vertebrae, anus, heart, trachea, esophagus, kidney, and limbs)-associated conditions can manifest with complex ocular abnormalities.
- Neurotrophic keratopathy, a loss of corneal sensation, poses a significant risk for ocular surface disease.
- Limbal dermoids are congenital tumors that can cause visual impairment and ocular surface issues.
Purpose of the Study:
- To describe a novel surgical technique combining corneal neurotization and limbal dermoid excision.
- To evaluate the efficacy and safety of this combined approach in a pediatric patient with VACTERL-associated ocular conditions.
Main Methods:
- A 4-year-old boy with VACTERL-associated bilateral neurotrophic keratopathy and a left limbal dermoid underwent bilateral corneal neurotization.
- Simultaneous excision of the left limbal dermoid was performed during the procedure.
Main Results:
- Corneal sensation significantly improved from 0 mm to 40 mm at 16 months post-operatively.
- The ocular surfaces remained stable with no reported complications.
- This represents the first documented case of combining corneal neurotization with dermoid excision.
Conclusions:
- Combined corneal neurotization and limbal dermoid excision is a viable and effective treatment for VACTERL-associated ocular surface disease.
- This approach can restore corneal sensation and maintain ocular surface health in pediatric patients.
- Further research is warranted to explore the long-term outcomes of this combined surgical strategy.
