Surgical Treatment of Epibulbar Malformations

Abstract

Aim. Analysis of the results of surgical treatment in patients with epibulbar malformations. Patients and Methods. The study included 126 patients with a preliminary diagnosis of “epibulbar neoplasm”, who received treatment from January 2013 to December 2017. Male patients were 57.9 % (n = 73), female — 42.1 % (n = 53). The age range was from 6 months to 82 years (13.0 ± 11.4). All patients underwent complex ophthalmological examination and surgical treatment with histological verification of the obtained material. In case of deficiency of own tissues, when the conjunctival defect was closed, plastic was made using an amniotic membrane. Results. 67 (53.2 %) patients had a diagnosis of dermoid of the conjunctiva and / or cornea. In 14.3 % of cases, a diagnosis of lipodermoid with spreading into the eyelids fornix was established. In 7 patients there was a combined lesion, of them in 4 cases with Goldenhar syndrome, 1 case with Jadassohn syndrome and in 2 cases without syndromic disorders. In 10 patients, multicentric lesions were noted with the formation of several dermoids. Choristomas of different structures were identified in 41 patients (32.5 %). Complications of surgical treatment included limitation of eye mobility (n = 9), ptosis of the upper eyelid (n = 7), diplopia (n = 4), ocular deformity (n = 3), corneal perforation (n = 1), symblepharon (n = 1) and entropion (n = 1), which required additional surgical interventions with a favorable functional outcome. Conclusions. Diagnosis of epibulbar malformations requires a comprehensive ophthalmological examination to determine the prevalence of the process, the extent of the lesion in order to plan the timing and tactics of surgical treatment. Congenital epibulbar malformations of the eye are subject to surgical treatment with the growth of lesion, chronic inflammation, cosmetic dissatisfaction and spread to the central parts of the cornea. The use of the amniotic membrane improves normal epithelization and reduces the degree of postoperative scar deformation.