Surgical treatment of capillary hemangiomas causing amblyopia.
Publication/Presentation Date
6-1-2007
Abstract
BACKGROUND: Capillary hemangiomas of the eyelids and orbit can cause refractive and occlusive amblyopia. Although oral and intralesional steroid injections are the most common treatment modalities, sometimes they are not successful. There is a paucity of information in the literature on the success of eliminating amblyogenic factors by treating these lesions with surgical resection.
METHODS: Retrospective chart review of 10 patients in two pediatric ophthalmology practices who underwent surgical excision of a capillary hemangioma that was causing amblyopia and that had failed to regress with other treatment.
RESULTS: Two patients had surgery secondary to pupillary occlusion, which was successful in relieving occlusion. Eight patients had surgery secondary to significant astigmatism. The average preoperative astigmatic difference between the affected and unaffected eye in five of these patients undergoing surgery before the age of 21 months was 2.15 D. The average postoperative astigmatic difference was 0.1 D. The average preoperative astigmatic difference between the affected and unaffected eye in three patients undergoing surgery after 21 months of age was 1.6 D. Surgery completely failed to reduce the astigmatism in two of these patients. The third patient had a decrease of 0.75 D of cylinder but still had a difference of 1.75 D between the two eyes postoperatively. Postoperative complications in this study included wound infection in one patient.
CONCLUSIONS: Surgical excision of capillary hemangiomas that were resistant to other modes of treatment was useful in relieving pupillary occlusion and in decreasing the amount of astigmatism if performed before the age of 21 months in our series of patients. Our cases as well as the literature suggest that surgery should be performed at 13 months or earlier to reduce the amount of astigmatism.
Volume
11
Issue
3
First Page
230
Last Page
234
ISSN
1091-8531
Published In/Presented At
Levi, M., Schwartz, S., Blei, F., Ceisler, E., Steele, M., Furlan, L., Millman, A., & Kodsi, S. R. (2007). Surgical treatment of capillary hemangiomas causing amblyopia. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 11(3), 230–234. https://doi.org/10.1016/j.jaapos.2006.12.048
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
17344079
Department(s)
Department of Pediatrics
Document Type
Article