title: Epithelial downgrowth after cataract surgery: an atypical presentation with scleral thinning and massive seeding in anterior chamber.
abstract: OBJECTIVE
  To report an atypical presentation of epithelial downgrowth (ED) after clear cornea cataract extraction, characterized by mixed clinical expression of both cystic and diffuse form and massive epithelial debris seeding in anterior chamber, associated with scleral involvement.
  
  
  METHODS
  In this case report, fine needle anterior chamber aspiration cytology was performed to identify pathologic tissue invading iris, cornea, and angular structures. The patient was treated with anterior chamber membrane surgical excision.
  
  
  RESULTS
  Epithelial downgrowth was identified by cytologic assessment. The patient was treated with epithelial membrane peeling and scleral defect conjunctival covering. This conservative surgical approach led to a significant reduction of ocular pain. During follow-up, residual epithelial tissue was present in anterior chamber without tendency to regrowth.
  
  
  CONCLUSIONS
  In doubtful cases of ED, histocytopathologic analysis should be performed without hesitation. Avoiding more invasive procedures, early detection and prompt surgical approach can result in improved outcome even in case of extensive intraocular involvement.
authors.affiliation: Ophthalmology Unit, Ca'Foncello Hospital, Treviso - Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scarpa
authors.affiliation: Neuroscience Department, Ophthalmology Unit, University of Padua, Padua - Italy.
authors.forename: Alvise
authors.initials: A
authors.lastname: La Gloria Valerio
authors.affiliation: Ophthalmology Unit, Ca'Foncello Hospital, Treviso - Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Urban
authors.affiliation: Pathology Unit, Ca'Foncello Hospital, Treviso - Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Laurino
mesh_terms: D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology*; D003315:Cornea / Q000601:surgery; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D008866:Microsurgery; D018918:Phacoemulsification / Q000009:adverse effects*; D015422:Scleral Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery