Surgical treatment of an intrastromal epithelial corneal cyst

Purpose. To describe corneal intrastromal epithelial cysts and present a mi nimally invasive surgical technique successfully used to treat such a lesio n. Methods. A 5-year-old girl with a progressive, vision-threatening, intra stromal corneal opacity in the left eye is described. The patient had a his tory of accommodative esotropia and bilateral medial rectus recession two y ears before presentation. A presumptive diagnosis of an epithelial cyst sec ondary to iatrogenic seeding of the limbal corneal stroma was made. Because of documented growth toward the visual axis and a decrease in best-correct ed visual acuity, surgical treatment was initiated. The cyst was incised an d debrided through a 2.0-mm, partial-thickness, limbus-parallel, clear corn eal incision. Results. Cytologic analysis of the cyst contents showed intac t and degenerated epithelial cells, thereby confirming the diagnosis. The c yst walls were scraped through the nonenlarged incision, and irrigation res ulted in nearly complete clearing of the opacity. Stable vision and no recu rrences were documented with 21 months of follow-up. Conclusion. This minim ally invasive surgical approach may be a good alternative to previously des cribed treatments for intrastromal corneal cysts.