Surgical treatment of limbal vernal keratoconjunctivitis by resection of a limbal lesion.

Purpose: To report our experience managing a limbal mass associated with limbal vernal keratoconjunctivitis (VKC) by surgical excision.

Methods: A 16-year-old girl was referred to our hospital with the chief complaints of itching and photophobia in both eyes. She had a 2-year history of gradually enlarging limbal gelatinous masses on the temporal limbus in both eyes, which were diagnosed as limbal papillae of VKC. As the symptoms in her left eye were more severe, surgical resection of the limbal mass in her left eye was performed to relieve mechanical stress on the eyelid, followed by a free conjunctival autograft taken from the supranasal bulbar conjunctiva.

Results: After excision of the mass, ocular inflammation and other symptoms gradually disappeared. At 12-month follow-up, there was no recurrence of the mass. Findings in a histological examination of the excised limbal lesion were consistent with those of limbal papilla of VKC.

Conclusion: In recalcitrant cases of limbal VKC, in which the symptoms are apparently caused by an elevated limbal mass, surgical excision of the limbal mass can be one of the therapeutic modalities, and it may facilitate resolution of the symptoms caused by chronic limbal VKC.