Intrastromal corneoscleral epithelial cyst

Abstract

Introduction: Intrastromal corneal cyst (ISCC) is very rare corneal pathology. There are only 16-17 cases described in the literature. ISCC may be primary (congenital) or secondary (acquired) as a result of injury, inflammatory process etc. The diagnostics & treatment rather difficult due to rarity observations. The item of this work was to work out the diagnostic criteria & treatment possibilities of ISCC. Material and methods: Child H., 8y.o. with intermittent corneal opacification was carried out a full ophthalmological examination & surgical treatment. Results: Complaints: the reduction of visual acuity of the right eye, intermittent corneal clouding with a tendency to increase. Objectively: blepharospasm, photophobia, mixed injection, 2 cystic formation of the limbus at 6 o`clock ongoing intrastromal pseudohypopion. Visual acuity – 0.06 uncorrected, IOP – 15.0mm. US-scan revealed intrastromal corneal cystic cavity. Treatment: I stage – conservative antibiotic & inflammatory therapy – without success. II stage – surgical intervention revision of the scleral cyst drainage & BSS sodium solution irrigation the ISCC with closed cryodestruction of corneal & scleral cysts. After operation – residual corneal clouding. Visual acuity rised to 0.2. Conclusion 1. The migration of epithelial cells into the corneal stroma with its subsequent proliferation plays a key role in ISCC formation. 2. The drainage of ISCC with BSS solution irrigation & closed cryodestruction – the safest method of treatment in pediatrics.