Deep anterior lamellar keratoplasty for an intrastromal epithelial corneal cyst: a case report

Trans-stromal epithelial cyst after multiple lamellar keratoplasties - Case report and review of literature

“…The authors reported that DALK was required to treat the cyst, which had extended deep into the central corneal stroma and occupied a significant portion of the visual axis. 15 In our case, the patient had corneal edema prior to developing the corneal ulcer, suggesting corneal endothelial cell failure that required a transplant of both Descemet's membrane and endothelium. Because of the scar that developed in the stroma after the ulcer, it was also necessary to replace the stroma to restore optical clarity.…”

“…2) LK complicated by perforation of posterior corneal lamella, and subsequently converted to PK. No recurrence of cyst in cornea and anterior chamber at POM 20 Bhatt et al 12 2007 Eye 10yo F 5 × 5.2 mm Mid-stroma Iatrogenic seeding of corneal stroma from limbal traction suture (prior strabismus surgery) Cyst incision, irrigation, and drainage No recurrence of cyst in cornea and anterior chamber at POM 6 Lazzaro et al 11 2012 Eye & Contact Lens 64yo M 5 × 7 mm Anterior stroma Prior ocular surgeries (glaucoma surgery, cataract extraction) Serial monitoring No change in size or appearance at 5-month follow-up Li et al 15 2018 Canadian Journal of Ophthalmology 25yo M 6 mm Anterior to deep stroma Ocular trauma from an awl (small tool used for piercing) DALK No recurrence of cyst in cornea and anterior chamber at POM 6 Reed et al 7 1971 Arch Ophthal 1) 15yo M 2) 10yo M 3) 70yo M 4) 9yo M 5) 4yo F 6) 2yo M 7) 22mo F 8) 25yo M 1) 7 × 7 mm 2) 4 × 4 mm 3) 3 × 3 mm 4) 5 × 4 mm 5) 3 × 2 mm 6) 6 × 5 mm 7) 6 × 5 mm 8) 5 × 2 mm 1) Mid-stroma 2) Mid-stroma 3) Deep stroma 4) Deep stroma 5) Mid-stroma 6) Mid-stroma 7) Mid-stroma 8) Deep-stroma 1) Prior ocular surgery (congenital cataract extraction) 2) Traumatic hyphema irrigated at age 8 3) Cataract extraction at age 68 4) Unknown 5) Unknown 6) Unknown 7) Unknown 8) Unknown 1) Incision 2) Excision of anterior wall; conjunctiva sutured to posterior lip 3...…”

Surgical Treatment of a Corneal Epithelial Cyst

“…C orneal epithelial cysts are rare, benign, and slowly progressive lesions usually caused by implantation of corneal epithelium into the stroma. 1,2 Most corneal cysts originate from a scleral component. These are described as congenital and progressive in course, although scleral cysts without corneal involvement have been reported.…”

“…6 Different treatments have been advocated, including simple cyst aspiration and drainage, cyst wall excision, chemical cautery, electrical cautery, cryotherapy, and lamellar or penetrating keratoplasty. [2][3][4] Chemical treatments include 10% acetic acid, 1% iodine, cocaine, distilled water, 20% trichloroacetic acid, and 96% ethanol. 1,2,4 Despite such treatments, recurrence is common after surgery, and the surgery itself may have negative visual consequences.…”

“…[2][3][4] Chemical treatments include 10% acetic acid, 1% iodine, cocaine, distilled water, 20% trichloroacetic acid, and 96% ethanol. 1,2,4 Despite such treatments, recurrence is common after surgery, and the surgery itself may have negative visual consequences. 3 In this study, we present a rare case of a recurrent developmental corneoscleral cyst after drainage, successfully managed using a combined surgical technique including drainage and irrigation with distilled water with sectorial corneoscleral transplantation.…”