Dr.PRIYADARSHINI KAMALAKANNAN

, Dr.PRAFULLA KUMAR MAHARANA, DR. NAMRATA SHARMA

Abstract

A 6-month-old male child presented with a massive dermoid extending up to >2/3rd of the cornea sparing a small part of the cornea nasally with suspected full thickness involvement noted on Ultrasound Bio-microscopy. Following an initial superficial debulking using blunt dissection, MIOCT showed a shallower anterior segment temporally with crowding of angle structures and a remnant of the Descemet membrane-endothelial layer complex could be observed. This encouraged us to go ahead with a lamellar graft. The rim of the dermoid was left on the corneal side to act as a ledge for graft suturing and a ledge plane was created on the scleral side as well. An oval graft was trephined with a vertical diameter of 10mm and horizontal diameter of 6mm after stripping the Descemet’s membrane and sutured with interrupted sutures. The conjunctiva was then advanced and sutured. Thus we could manage this difficult case of dermoid with a lamellar procedure rather than a full thickness keratoplasty.