Ocularis Oftalmologia Avançada and Universidade Federal do Paraná (Federal University of Paraná), Curitiba, Brazil.
Cornea. 2021 Nov 1;40(11):1498-1501. doi: 10.1097/ICO.0000000000002677.
To describe a case of intracorneal epithelial cyst and present a surgical technique successfully used to treat this patient.
This interventional case report presents a 4-year-old boy with a progressive intrastromal corneal opacity and decreased vision in his right eye. The patient had no previous history of trauma or ocular surgery. After clinical examination and corneal optical coherence tomography, a presumptive diagnosis of a developmental epithelial cyst was made, and surgery was indicated. Four years later, when the patient was 8 year old, he returned after having performed drainage of the cyst in another service but still complaining of low vision. The biomicroscopy showed an intrastromal recurrent cyst. At this time, we recommended the surgical retreatment. The cyst was drained, a lamellar keratosclerectomy was performed at the site of the limbus where the epithelial nest was placed, and distilled water was used to wash the corneal cyst - to eliminate the epithelial cells. A donor cornea button was cut manually and was transplanted to cover the area where the corneoscleral tissue was removed.
The surgical technique described resulted in nearly complete clearing of the opacity and improved vision, and no recurrence was documented up to 19 months of follow-up. The best-corrected visual acuity improved from 20/100 before surgery to 20/30 after surgery.
This surgical technique may be a good alternative to other previously described treatments for intracorneal epithelial cysts aiming to avoid recurrence and without the need for central corneal transplantation.
描述一例角膜上皮内囊肿病例，并介绍一种成功用于治疗该患者的手术技术。
本介入性病例报告介绍了一例 4 岁男孩，其右眼出现进行性基质内角膜混浊和视力下降，无外伤或眼部手术史。经过临床检查和角膜光相干断层扫描，诊断为发育性上皮囊肿，并建议手术。4 年后，当患者 8 岁时，他在另一家医院进行了囊肿引流后返回，仍抱怨视力低下。生物显微镜检查显示基质内复发性囊肿。此时，我们建议再次手术治疗。排出囊肿后，在放置上皮巢的角膜缘处行板层角巩膜切除术，并使用蒸馏水冲洗角膜囊肿以清除上皮细胞。手动切割供体角膜纽扣并移植覆盖去除角巩膜组织的区域。
所描述的手术技术导致混浊几乎完全清除，视力得到改善，随访 19 个月未见复发。最佳矫正视力从术前的 20/100 提高到术后的 20/30。
与其他先前描述的治疗角膜内上皮囊肿的方法相比，这种手术技术可能是一种较好的选择，旨在避免复发，且无需进行中央角膜移植。
