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Portable OCT-assisted surgical treatment of intracorneal pre-Descemet epithelial cyst: a case report

Authors
 Sang Woo Kim  ;  Eung Kweon Kim 
Citation
 BMC Ophthalmology, Vol.17(1) : 160, 2017 
Journal Title
 BMC Ophthalmology 
Issue Date
2017
MeSH
Child, Preschool ; Corneal Diseases/surgery* ; Cysts/surgery* ; Descemet Membrane/pathology* ; Female ; Humans ; Ophthalmologic Surgical Procedures/methods* ; Point-of-Care Systems* ; Surgery, Computer-Assisted/methods* ; Tomography, Optical Coherence* ; Treatment Outcome
Keywords
10% Trichloroacetic acid ; Case report ; Deep-seated intracorneal epithelial cyst ; Fourier-domain optical coherence tomography
Abstract
BACKGROUND: Intracorneal epithelial cysts are a rare clinical condition that can occur anywhere in the corneal tissue; however, they appear most commonly in the stroma. They are sometimes challenging to treat because of their location, depth, and visual outcomes. Herein, we report a pre-Descemet epithelial cyst that was successfully treated surgically, with guidance from Fourier-domain optical coherence tomography (FD-OCT). CASE PRESENTATION: This interventional case report presents a patient with gradually decreasing vision caused by a pre-Descemet epithelial cyst. A 4-year-old girl with no history of trauma or ocular surgery showed a deep-seated intracorneal cyst in her left eye (8 o'clock corneoscleral area, dissecting into the pre-Descemet cornea). The cyst was threatening the visual axis. An epithelial cyst was diagnosed after drainage on the basis of the cyst contents. We irrigated inside the cyst using 10% trichloroacetic acid (TCA), distilled water, and 1% 5-fluorouracil (5-FU) solutions for chemical cyto-destruction of the lining epithelial cells of the cystic wall. We used a portable FD-OCT during operation to guide this procedure, without perforating the Descemet's membrane and endothelial layer. Recurrence could be prevented after removal of the cystic tissue located in the sclera area outside of the limbus. No recurrence was noted during the 4-year follow-up. CONCLUSION: When treating centrally deep-seated intracorneal epithelial cysts, clinicians must consider recurrence, endothelial damage, and visual outcome. Herein we report the case of a deep-seated, intracorneoscleral epithelial cyst that was completely resolved with chemical cyto-destruction and removal of the intrascleral cystic tissue under the guidance with FD-OCT; thus, endothelial damage could be minimized.
DOI
10.1186/s12886-017-0558-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
김응권(Kim, Eung Kweon) ORCID logo https://orcid.org/0000-0002-1453-8042
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160966
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