Haller Julia A, Stark Walter J, Azab Amr, Thomsen Robert W, Gottsch John D
Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Am J Ophthalmol. 2003 Mar;135(3):309-13. doi: 10.1016/s0002-9394(02)01960-8.
To review management strategies for treatment of anterior chamber epithelial cysts.
Retrospective review of consecutive interventional case series.
Charts of patients treated for epithelial ingrowth over a 10-year period by a single surgeon were reviewed. Cases of anterior chamber epithelial cysts were identified and recorded, including details of ocular history, preoperative and postoperative acuity, intraocular pressure (IOP), and ocular examination, type of surgical intervention, and details of further procedures performed.
Seven eyes with epithelial cysts were identified. Patient age ranged from 1.5 to 53 years at presentation. Four patients were children. In four eyes, cysts were secondary to trauma, one case was presumably congenital, one case developed after corneal perforation in an eye with Terrien's marginal degeneration, and one case developed after penetrating keratoplasty (PK). Three eyes were treated with vitrectomy, en bloc resection of the cyst and associated tissue, fluid-air exchange and cryotherapy. The last four eyes were treated with a new conservative strategy of cyst aspiration (three cases) or local excision (one keratin "pearl" cyst), and endolaser photocoagulation of the collapsed cyst wall/base. All epithelial tissue was successfully eradicated by clinical criteria; one case required repeat excision (follow-up, 9 to 78 months, mean 45). Two eyes required later surgery for elevated IOP, two for cataract extraction and one for repeat PK. Final visual acuity ranged from 20/20 to hand motions, depending on associated ocular damage. Best-corrected visual results were obtained in the more conservatively managed eyes.
Anterior chamber epithelial cysts can be managed conservatively in selected cases with good results. This strategy may be particularly useful in children's eyes, where preservation of the lens, iris, and other structures may facilitate amblyopia management.
回顾前房上皮囊肿的治疗管理策略。
对连续的介入病例系列进行回顾性研究。
回顾由一位外科医生在10年期间治疗上皮内生患者的病历。识别并记录前房上皮囊肿病例，包括眼部病史细节、术前和术后视力、眼压（IOP）、眼部检查、手术干预类型以及进一步手术操作的细节。
识别出7例有上皮囊肿的眼睛。就诊时患者年龄在1.5岁至53岁之间。4例患者为儿童。4只眼中，囊肿继发于外伤，1例可能为先天性，1例在患有特里安角膜边缘变性的眼睛角膜穿孔后发生，1例在穿透性角膜移植术（PK）后发生。3只眼接受了玻璃体切除术、囊肿及相关组织的整块切除、液 - 气交换和冷冻疗法。最后4只眼采用了新的保守策略，即囊肿抽吸（3例）或局部切除（1例角质“珍珠”囊肿），并对塌陷的囊肿壁/底部进行内激光光凝。根据临床标准，所有上皮组织均成功根除；1例需要重复切除（随访9至78个月，平均45个月）。2只眼后来因眼压升高需要手术，2只眼因白内障摘除需要手术，1只眼因重复PK需要手术。最终视力范围从20/20到手动视力，取决于相关的眼部损伤。在采用更保守治疗的眼中获得了最佳矫正视力结果。
在某些选定病例中，前房上皮囊肿可以采用保守治疗，效果良好。这种策略在儿童眼中可能特别有用，因为保留晶状体、虹膜和其他结构可能有助于弱视治疗。
