EPITHELIAL INTERFACE CYSTS AFTER EPIKERATOPHAKIA

Background. Epithelial interface cysts have been occasionally observed after lamellar keratoplasty. The authors report the incidence, clinic al significance, and management of this complication in epikeratophaki a patients. Methods: From August 1987 to January 1991, 108 consecutive patients undergoing epikeratophakia entered a prospective study aimed at evaluating both clinical results and changes in corneal physiologi c parameters. After an average hospitalization of 6 days, all patients underwent complete ophthalmologic examinations at regular intervals a fter surgery. All postoperative complications, including the developme nt of epithelial interface cysts, were recorded and photographed. Resu lts: Over a 3-year period, epithelial interface cysts were observed in 8 eyes, with an overall incidence of 7.4%. All cysts originated under the periphery of the epilens. In five patients, the cysts enlarged ce ntripetally but eventually ceased to grow, causing no visual impairmen t. In two patients, after an initial increase in size the cysts slowly regressed and finally disappeared. In only one patient, a cyst migrat ed over the visual axis, thus necessitating surgical removal. The cyst did not recur during an observation time of 18 months after debrideme nt, allowing full recovery of visual acuity. Conclusion: The incidence of epithelial interface cysts after epikeratophakia is relatively hig h. Because of their peripheral location and self-limited growth, the c linical significance of this complication is low. The possibility of s pontaneous regression of the cysts supports a conservative approach, a s long as the visual axis is not affected. Surgical removal is possibl e without compromising the epi-lens and is compatible with an excellen t visual outcome.