Longitudinal Study of Epibulbar Dermolipomas Over Five-Year Follow-Up: Growth Analysis, Refractive Errors, and Surgical Outcomes.

Purpose: To evaluate the growth, management, and outcomes of epibulbar dermolipomas over a 5-year follow-up period.

Methods: This was a retrospective chart review of epibulbar dermolipoma patients with a minimum follow-up of 5 years, which analyzed the changes in size, refractive errors (spherical equivalent), best-corrected visual acuity, histology, and surgical outcomes.

Results: A total of 61 eyes of 53 patients (32 females) with an average presenting age of 4.4 years were included. Eight patients had bilateral involvement, and 22 (41.5%) had Goldenhar syndrome. Forty-one eyes had corneal and conjunctival involvement, and 12 had only conjunctival involvement. Forty-five eyes (73.7%) had refractive errors, and 39 (63.9%) were amblyopic. The average lesion size was 8.3 ± 6.1 by 7.4 ±4.9 mm and 7.1 ± 5 by 7.5 ±5.4 mm in operated and unoperated eyes, respectively. Of 61 eyes, 30 underwent simple surgical excision with conjunctival autograft (3), amniotic membrane graft (7), partial thickness corneal transplant (18), and amniotic membrane graft plus limbal epithelial transplant (2). Fifty-five (90%) of operated eyes had better cosmesis and a significant change in refractive error (p = 0.003). The best-corrected visual acuity improved in operated eyes by 0.4 logMAR units (p = 0.05). A mean size increase of 0.4 ± 0.8 by 0.4 ± 0.9 mm occurred in 31 eyes managed conservatively, with improved best-corrected visual acuity but no change in refractive errors. Amblyopic eyes showed improvement in best-corrected visual acuity of 0.7 (p = 0.007) after occlusion therapy in 13 unoperated and 26 operated eyes.

Conclusion: Epibulbar dermolipomas often have associated refractive errors and amblyopia. Timely surgical excision improves cosmesis and refractive errors. Occlusion therapy for amblyopic eyes should be offered to help improve vision.