Peripheral lamellar keratoplasty for corneoscleral cyst: Three case reports

Purpose. To examine whether peripheral lamellar keratoplasty (LKP) using pr eserved cornea was effective for the treatment of corneoscleral cysts, Meth ods. Three patients with corneoscleral cysts underwent peripheral lamellar keratoplasty. Two patients had no history of trauma or ocular surgery and w ere considered to have congenital cysts. The other patient had a history of strabismus surgery that had been performed 7 years previously. The anterio r wall of the cysts was removed by trephination, and the epithelial membran e lining the posterior wall was peeled off. Lamellar corneal buttons obtain ed from preserved corneas then were put in place and secured with 8-10 inte rrupted sutures. In one case, because the cyst was large and extended to th e pupillary axis, peripheral LKP was performed for removal of the scleral a nd peripheral corneal cyst, and the inner wall of the central corneal cyst was removed with vigorous irrigation and a spatula. Results. Histologic exa mination showed that all of the cysts were lined with nonkeratinizing epith elial cells. In all three cases, cysts have not reformed after a 1-5-year f ollow-up. Conclusions. The cysts were lined in epithelial cells, and remova l of these epithelial cells was considered to be important for the preventi on of recurrence. Peripheral LKP is effective for the treatment of corneosc leral cysts, since this procedure removes displaced epithelial cells and re constructs the thin part of the cornea and sclera.