Corneal intrastromal cyst

Anterior segment optical coherence tomography of intrastromal corneal donor lenticule for recurrent intrastromal epithelial inclusion cyst in a corneal graft

Intracorneal cysts are uncommon lesions that occur either due to congenital or traumatic pathology. Treatments described include cyst excision, drainage or intracyst injection of chemical solutions, such as ethanol. Recurrences commonly occur with these modalities and there is no clear consensus on the best approach to take. In this article, the authors present a rare case of a recurrent intrastromal epithelial corneal cyst following suture removal in an 11-year-old boy who had undergone optical penetrating keratoplasty in his left eye. It was managed effectively with an innovative technique of lamellar excision and donor corneal stromal lenticule lamellar placement to prevent recurrence. Serial postoperative anterior segment optical coherence tomography (ASOCT) was performed to monitor for cyst recurrence. No recurrence was observed for one and a half years with clear corneal graft. ASOCT is an effective tool in the diagnosis and follow-up of a recurrent intrastromal epithelial inclusion cyst.

Massive intracorneal cyst in a patient with no ocular symptoms

OBJECTIVE

To report a rare case of intracorneal cyst with no ocular symptoms.

METHODS

A case report of an intracorneal cyst that was treated with lubrication and intraocular pressure lowering medication is discussed.

RESULTS

There was no increase in cyst size nor were there any new symptoms reported after 5 months of follow-up.

CONCLUSIONS

Intracorneal cysts are believed to be caused by a sequestration of corneal limbal cells in the stroma from congenital or traumatic reasons. Because of the slow growing nature of intracorneal cysts, we highlight that surgical excision is not always warranted in patients, especially if the vision is already poor and if no symptoms are present.

Surgical treatment of an intrastromal epithelial corneal cyst

PURPOSE

To describe corneal intrastromal epithelial cysts and present a minimally invasive surgical technique successfully used to treat such a lesion.

METHODS

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.

RESULTS

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.

CONCLUSION

This minimally invasive surgical approach may be a good alternative to previously described treatments for intrastromal corneal cysts.

Transformation of corneal epithelial cyst into anterior chamber implantation cyst and scleral cyst: a rare occurrence

An 8-year-old boy underwent a penetrating keratoplasty for a corneal epithelial cyst. After surgery an anterior chamber implantation cyst appeared. Repeated Neodymium:YAG (Nd:YAG) laser treatments failed to eradicate this cyst; it later extended into the sclera together with the collapse of the anterior chamber cyst. The possible mechanism underlying the development of these cysts is discussed.

Traumatic intrastromal corneal cyst

This case report describes the clinical and pathological characteristics of an intrastromal epithelial corneal cyst. This lesion tends to occur after relatively minor trauma, in younger patients, and is a slowly progressive disorder that develops over many years. The eye shows no signs of inflammation. The cyst typically appears opalescent but may be characterized by a fluid level. Pathologically, the cyst cavity is lined by cells with features similar to those of limbal corneal eplithelium. Treatment consists of removal or destruction of the epithelial cells lining the cavity.