En bloc excision of intraocular epithelial cystic downgrowth using syngeneic auricular cartilage.
OBJECTIVE
To describe the surgical management of epithelial cystic downgrowth by en bloc excision and use of syngeneic auricular cartilage in two children.


METHODS
Retrospective interventional case series.


METHODS
The charts of two patients treated for epithelial cystic downgrowth with en bloc excision and auricular cartilage transplant were reviewed. Details of ocular history, preoperative and postoperative visual acuity, intraocular pressure, ocular examination findings, surgical procedure and subsequent management were noted.


RESULTS
Two children aged 4 and 6 years, with epithelial cysts who underwent en bloc excision were identified. The cysts had developed following penetrating eye injury. Surgery involved en bloc resection of the cyst and associated tissue, and replacement of the excised corneoscleral tissue with syngeneic auricular cartilage. One patient additionally required synechiolysis, discission of a secondary cataract and anterior vitrectomy. In both cases, the epithelial tissue was successfully removed and the auricular cartilage transplant was well-apposed. Visual acuity remained at the preoperative level in the first patient due to amblyopia; in the second patient visual acuity improved to 6/7.5 with mild astigmatic correction.


CONCLUSIONS
En bloc excision provides the most definitive surgical treatment of cystic epithelial downgrowth. Auricular cartilage may be used for sclerokeratoplasty when donor cornea or sclera is unavailable.
Department of Ophthalmology, Sultan Qaboos University Hospital, Oman. ganeshs@omantel.net.om
A
A
Ganesh
N
N
Al-Fadhil
U
U
Wali
A A
AA
Bialasiewicz
D000867:Anterior Chamber / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004425:Ear Cartilage / Q000637:transplantation*; D005128:Eye Diseases / Q000209:etiology / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D006801:Humans; D008297:Male; D010781:Photography / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology