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

Abstract

Purposeto report the utility of Anterior Segment Optical Coherence Tomography (AS OCT) for planning superficial sclerectomy in a patient with nevus of Ota. ObservationsOculodermal 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 ImportanceIn 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.