Block excision and tectonic corneoscleral graft for recurren
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A 51-year-old patient with traumatic cystic epithelial ingrowth was treated 3 times with needle aspiration of the cyst and alcohol injections, but the cyst recurred shortly thereafter. The cyst was treated successfully at our department with block excision, vitrectomy, lens removal, intraocular lens implantation, and a tectonic corneoscleral graft. Histologic and electron microscopic examination showed the intact epithelial cells, 2 to 6 layers thick, lining the cyst. Ten months after surgery, there was no evidence of recurrence of the cyst and the pressure was controlled. Based on our experience, we do not think the alcohol injection technique leads to complete destruction of the epithelial cells and the cyst. Block excision with tectonic corneoscleral graft seems to be the method of choice for cysts involving fewer than 5 clock hours of the corneal circumference.

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