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Research Letters | Nov 2012

Cystic Epithelial Ingrowth in a Case of Deep Anterior Lamellar Keratoplasty

Jayangshu Sengupta, MS; Archana Khetan, MS

Arch Ophthalmol. 2012;130(11):1476-1478. doi:10.1001/archophthalmol.2012.509.

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In deep anterior lamellar keratoplasty (DALK), complications related to baring of the Descemet membrane such as incomplete exposure or perforations are well known.¹ Epithelial ingrowth, on the other hand, is rare following anterior lamellar keratoplasty and usually occurs as a sheet of cells across the interface.² Herein, we report the first case, to our knowledge, of a cystic pattern of epithelial downgrowth in a case of DALK and its subsequent management.

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Figure 1. Characteristics of epithelial ingrowth following deep anterior lamellar keratoplasty. A, Diffuse illumination view in slitlamp biomicroscopy demonstrating a cystic structure in the anterior chamber. B, Slitlamp section view demonstrating translucence of the cyst and clear graft interface. C, Ultrasound biomicroscopy demonstrating the thin cyst wall with attachment to the graft-host junction. D, Histopathological section showing the squamous lining of the cyst wall (hematoxylin-eosin, original magnification ×10).

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Figure 2. Postoperative clinical picture. A, Diffuse illumination. B, Slitlamp section view showing the clear graft and interface.

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Sengupta J, Khetan A. Cystic Epithelial Ingrowth in a Case of Deep Anterior Lamellar Keratoplasty. Arch Ophthalmol. 2012;130(11):1476-1478. doi:10.1001/archophthalmol.2012.509.

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