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JA Haller, WJ Stark, A Azab, RW Thomsen, JD Gottsch; Surgical Approaches to Cystic Epithelial Ingrowth . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4506.
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Purpose:To review management strategies for treatment of cystic epithelial ingrowth Methods:Retrospective chart review of a single surgeon's consecutive series of patients with epithelial ingrowth. Eyes with epithelial cysts were identified, and data collected including age, gender, history, preoperative examination, details of surgery, and postoperative examination including visual acuity, IOP, anatomic status, and further required procedures. Results:Seven eyes with epithelial cysts were identified. Age ranged from 1.5 to 53 years. 4 patients were children. In 5 cases the cysts were traumatic in origin, in 1 case congenital and in 1 case secondary to corneal perforation due to Terrien's marginal degeneration. 4 cases were treated with vitrectomy, en bloc excision of the cyst and associated tissue, fluid-air exchange, and cryotherapy. The last 3 cases were treated with a conservative strategy of cyst aspiration or local excision and laser photocoagulation of the collapsed cyst wall/base. In all cases, the epithelial tissue was successfully eradicated; 1 case required repeat excision (follow-up 3 mos-9 years, mean 5 years). Two eyes required later surgery for elevated IOP, and 1 for cataract extraction. Final visual acuity ranged from 20/20 to CF, depending on associated ocular damage. Best visual results were obtained in the conservatively managed eyes. Conclusion:Cyst-like epithelial ingrowth can be managed conservatively in selected cases with good results. This strategy may be particularly useful in children, where preservation of the lens, iris and other ocular structures may facilitate amblyopia management.
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