American Academy of Ophthalmology
Jenny Geh, FRCS, and colleagues at the Great Ormond Street Hospital for Children in London conducted a retrospective review of 18 children who underwent surgery to excise hemangiomas. The lesions had failed to respond to steroid therapy, or, in some cases, the child's parent had requested their removal.
Most hemangiomas are asymptomatic and do not cause functional problems. However, periocular hemangiomas may result in amblyopia because of occlusion of the visual axis, induction of anisometropia or secondary strabismus. The indication for surgery in this study was amblyopia or a threat to normal visual development, as well as cosmetic consideration in school-age children. Mean age at surgery was 22 months. Preoperative evaluation included imaging by ultrasound, magnetic resonance imaging or contrast computed tomography.
No rebound growth of the hemangioma was observed at final follow-up (range, one month to 4 years), and almost all patients experienced postoperative improvement. The researchers conclude that with appropriate indications and surgical technique, periocular hemangiomas in children can be safely and effectively excised.