Corneal transplantation in an infant with corneal dermoid.

A 1-month-old infant had a protuberant congenital corneal dermoid that extended into the anterior chamber. The dermoid was excised in two stages. A 12-mm lamellar keratectomy was followed three months later by a smaller (8-mm) penetrating keratoplasty. This technique minimized the complications associated with large corneal transplants and increased the chance of long-term success. The graft has remained transparent and the posterior segment appears to be normal. The infant can maintain constant fixation and recognize small objects and crawls without difficulty.