Mifflin M D, Byers T L, Elliot R, Hoffman R
Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, USA.
Cornea. 2001 Mar;20(2):222-5. doi: 10.1097/00003226-200103000-00025.
To describe corneal intrastromal epithelial cysts and present a minimally invasive surgical technique successfully used to treat such a lesion.
A 5-year-old girl with a progressive, vision-threatening, intrastromal corneal opacity in the left eye is described. The patient had a history of accommodative esotropia and bilateral medial rectus recession two years before presentation. A presumptive diagnosis of an epithelial cyst secondary to iatrogenic seeding of the limbal corneal stroma was made. Because of documented growth toward the visual axis and a decrease in best-corrected visual acuity, surgical treatment was initiated. The cyst was incised and debrided through a 2.0-mm, partial-thickness, limbus-parallel, clear corneal incision.
Cytologic analysis of the cyst contents showed intact and degenerated epithelial cells, thereby confirming the diagnosis. The cyst walls were scraped through the nonenlarged incision, and irrigation resulted in nearly complete clearing of the opacity. Stable vision and no recurrences were documented with 21 months of follow-up.
This minimally invasive surgical approach may be a good alternative to previously described treatments for intrastromal corneal cysts.
描述角膜基质内上皮囊肿，并介绍一种成功用于治疗此类病变的微创外科技术。
描述了一名5岁女孩，其左眼有进展性、威胁视力的角膜基质混浊。该患者在就诊前两年有调节性内斜视和双侧内直肌后徙病史。初步诊断为角膜缘角膜基质医源性种植继发上皮囊肿。由于记录显示囊肿向视轴生长且最佳矫正视力下降，因此开始进行手术治疗。通过一个2.0毫米的、部分厚度的、与角膜缘平行的透明角膜切口对囊肿进行切开和清创。
囊肿内容物的细胞学分析显示有完整和退变的上皮细胞，从而证实了诊断。通过未扩大的切口刮除囊肿壁，冲洗后几乎完全清除了混浊。随访21个月，视力稳定且无复发。
这种微创外科方法可能是治疗角膜基质内囊肿的一种优于先前描述治疗方法的良好选择。
