FEB 15, 2019
AAO 2018 Video Program
Dermolipomas are epibulbar choristomata that usually present as conjunctival and subconjunctival lesions in the superotemporal fornix. Excision must be performed in a controlled manner to prevent complications. This video introduces a simple surgical approach with radiofrequency (RF)-assisted microsurgery to excise dermolipomas with adherent conjunctiva en bloc while preserving unaffected conjunctiva and the palpebral lobe of the lacrimal gland, performing a pretenon dissection to protect the lateral rectus, and truncating the excision at the lateral fornix. Inherent hemostasis provided by RF provides for excellent visibility and planar tissue dissection. Ocular surface reconstruction with a sutureless amniotic membrane graft with Tisseel glue helps provide postoperative comfort and scarless cosmesis. Careful RF-assisted microsurgery and ocular surface reconstruction minimizes complications, accelerates recovery, prevents recurrence, and provides gratifying cosmetic outcomes.