A Novel Surgical Approach for Oculodermal Melanocytosis: Superficial Sclerectomy

Jung, Seung-Il; Kwon, Taejung; Zhang, Cheng C.; Chuck, Roy S.; Kwon, Ji Won

doi:10.1097/icl.0000000000000263

Cited by 4 publications

(6 citation statements)

References 8 publications

(11 reference statements)

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“…3 B). We performed a 250 μm superficial sclerectomy, observing, as also reported by other authors, 4 , 7 a lower pigmentation in the inner surface of the scleral flap ( Fig. 5 C).…”

Section: Discussionsupporting

confidence: 75%

“…Several authors have reported using different surgical techniques to reduce or cover scleral pigmentation in patients with oculodermal melanocytosis. 2 , 4 , 5 , 7 Each technique gives good results and has some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…In 2017 Jung et al 7 proposed a superficial sclerectomy as an alternative approach for oculodermal melanocytosis. This technique involves grabbing the sclera with forceps and performing a shallow, partial thickness scleral incision using scissors.…”

Section: Discussionmentioning

confidence: 99%

“…3 A), which could correspond to the cleavage plane described previously by Jung. 7 We performed a 200 μm superficial sclerectomy, peeling the superficial dissected sclera: at the end of the procedure, the scleral bed was cleaned of pigment ( Fig. 4 D).…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been used to reduce these black or brownish lesions, including flipped scleral flap, 4 sclera allograft 5 and the grabbing method. 2 Some authors have shown good results with superficial sclerectomy 7 : the main problem in this case is knowing how much scleral tissue should be removed to eliminate the pigmented area without weakening the sclera. We report the utility of Anterior Segment Optical Coherence Tomography (AS OCT) in the preoperative planning of superficial sclerectomy in a patient with nevus of Ota.…”

Section: Introductionmentioning

confidence: 99%

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Utility of anterior segment optical coherence tomography in the surgical planning of superficial sclerectomy in oculodermal melanocytosis (nevus of Ota): A case report and review of literature

Mularoni¹,

Rania²,

Forlini³

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose to report the utility of Anterior Segment Optical Coherence Tomography (AS OCT) for planning superficial sclerectomy in a patient with nevus of Ota. Observations Oculodermal melanocytosis, also called nevus of Ota, is a benign pigmentary disorder that involves the skin innervated by the first and second branches of the trigeminal nerve. To reduce these black or brownish lesions, different surgical treatments have been reported, such as flipped scleral flap, sclera allograft and the grabbing method. Superficial sclerectomy is a recent technique that has proven effective in improving scleral pigmentation. Although this procedure allows the operating time to be reduced and results in a smoother scleral bed surface, it has a limitation, represented by the difficulty of estimating the depth of the sclerectomy: an inaccurate estimate or incorrect depth could cause an inadequate deep scleral dissection with excessive weakening of the sclera. We report a case of a 27-year-old patient with nevus of Ota undergoing superficial sclerectomy. The depth of scleral pigmentation was evaluated with AS OCT images before the surgery, allowing a superficial sclerectomy to be performed with a precalibrated diamond blade. Conclusions and Importance In oculodermal melanocytosis (nevus of Ota) the use of AS OCT images showing the depth of scleral pigmentation could lead to the most effective and safest surgical choice for each case.

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“…3 B). We performed a 250 μm superficial sclerectomy, observing, as also reported by other authors, 4 , 7 a lower pigmentation in the inner surface of the scleral flap ( Fig. 5 C).…”

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utility of anterior segment optical coherence tomography in the surgical planning of superficial sclerectomy in oculodermal melanocytosis (nevus of Ota): A case report and review of literature

Mularoni¹,

Rania²,

Forlini³

et al. 2021

American Journal of Ophthalmology Case Reports

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An update on ophthalmological perspectives in oculodermal melanocytosis (Nevus of Ota)

Abdolrahimzadeh

Pugi

Manni

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To provide a review of the literature on oculodermal melanocytosis (ODM) with a focus on the diagnostic and therapeutic implications of multimodal imaging techniques in the management of ophthalmic complications. Methods The authors carried out a literature search on PubMed, Medline, and Scopus of English language articles published on ODM through August 2021. This review presents traditional and novel diagnostic methods in the diagnosis and follow-up of patients with particular emphasis on addressing the role of imaging in the management of the ophthalmic complications of the condition towards improving current practice patterns. Results ODM is a rare, prevalently unilateral, congenital condition that presents with brown or blue/gray flat asymptomatic lesions of the skin, mucosae, episclera/sclera, and uvea localized within the territory of distribution of the ophthalmic and mandibular branches of the trigeminal nerve. Glaucoma and predisposition to uveal melanoma are the main ophthalmic complications. Diagnosis and management are through comprehensive opthalmological examination and traditional imaging methods such as ultrasonography and fluorescein/indocyanine green angiography as pigmentation of the fundus can conceal subtle retinal and choroidal alterations. Anterior segment optical coherence tomography and ultrasound biomicroscopy are used to evaluate the anterior segment and the ciliary body in the presence of glaucoma or melanoma of the anterior uveal tract. Fundus autofluorescence and retinal pigment epithelium (RPE) alterations are of aid in the differential diagnosis between choroidal nevi and melanoma. Enhanced depth imaging spectral domain optical coherence tomography offers outstanding in vivo evaluation of the dimensions and details of tumors or nevi and surrounding choroidal tissues and small choroidal melanomas may show distortions of the retinal and sub-retinal profile, presence of intra and sub-retinal fluid, abnormalities of the RPE, and compression of the choriocapillaris. Conclusions Novel multimodal imaging techniques are significant in the diagnosis and management of the ophthalmic complications of ODM. Fundus autofluorescence and enhanced depth spectral domain optical coherence tomography have adjunctive value in the detection of early-stage melanoma and differential diagnosis between nevi and melanoma. Awareness of current and emerging imaging techniques can propagate improved standardized definition and assessment of the complications of ODM.

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Ocular manifestations in phakomatosis pigmentovascularis: Current concepts on pathogenesis, diagnosis, and management

Abdolrahimzadeh

Pugi

Paula

et al. 2021

Survey of Ophthalmology

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A Novel Surgical Approach for Oculodermal Melanocytosis: Superficial Sclerectomy

Abstract: Superficial scleral separation is an effective procedure for cosmetic improvement of oculodermal melanocytosis.

Cited by 4 publications

References 8 publications

Utility of anterior segment optical coherence tomography in the surgical planning of superficial sclerectomy in oculodermal melanocytosis (nevus of Ota): A case report and review of literature

Utility of anterior segment optical coherence tomography in the surgical planning of superficial sclerectomy in oculodermal melanocytosis (nevus of Ota): A case report and review of literature

An update on ophthalmological perspectives in oculodermal melanocytosis (Nevus of Ota)

Ocular manifestations in phakomatosis pigmentovascularis: Current concepts on pathogenesis, diagnosis, and management

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