Abstract
Objectives
The objective of this study is to determine the factors that predict long-term changes in refraction after lamellar keratoscleroplasty in paediatric patients with limbal dermoids.
Methods
A retrospective study of 66 children with limbal dermoids who had lamellar keratoscleroplasty correction with more than 1-year follow-up. Univariate and multivariate regression analyses were performed to investigate factors associated with the long term in refractive parameters, including spherical equivalent, astigmatism, and mean keratometry. The change value was defined as the postoperative refractive value minus the preoperative refractive value. The lower the value of changes, the more satisfied the effects on the correction of the preoperative refraction.
Results
A total of 66 patients (mean surgical age: 3.5 ± 2.1 years) were assessed with at least 1-year follow-up. Amblyopia treatment duration was the only independent factor predicting the long-term changes in spherical equivalent between baseline and last follow-up visit (β = −0.030, P < 0.001). Lesion encroachment on the central and paracentral cornea (β = 0.502, P = 0.024), suture-related complications (β = 1.571, P < 0.001) and graft rejection (β = 0.983, P = 0.035) were significantly correlated with long-term changes in astigmatism. The long-term changes in refraction were not correlated with surgical age, lesion size, lesion depth, steroid-induced high intraocular pressure and changes in mean keratometry.
Conclusion
Suture-related complications and graft rejection should be carefully observed and appropriately treated in order to avoid the possible postoperative increase in astigmatism, especially for patients with lesion encroachment on the central and paracentral cornea. The long-duration amblyopia treatment after surgery appears to have a better correction effect on spherical equivalent in the long term, compared with astigmatism.
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Acknowledgements
We thank Yujin Zhao, Xiaoyan Li and Yidan Fan for assisting in preparation of this paper. All of them above were from the Department of Ophthalmology, Eye, Ear, Nose & Throat Hospital of Fudan University.
Funding
The authors were supported by grants from the National Natural Science Foundation of China (81670820, 81670818 and 81870630); the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning; Shanghai Rising-Star Program (18QA1401100); and the Guizhou Science and Technology Program (2016–2825). The sponsor or funding organisation had no role in the design or conduct of this research.
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Fan, X., Hong, J., Xiang, J. et al. Factors predicting long-term changes in refraction after lamellar keratoscleroplasty in children with limbal dermoids. Eye 35, 1659–1665 (2021). https://doi.org/10.1038/s41433-020-01140-2
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DOI: https://doi.org/10.1038/s41433-020-01140-2
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