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Wydanie 3/2004

Epithelial ingrowth after cataract surgery

Zbigniew Zagórski

Skubiszewski Medical University Tadeusz Krwawicz Chair of Ophthalmology and 1st Eye Hospital Chairman: Zbigniew Zagórski, MD, PhD

Summary: Purpose: to review the pathogenesis of different forms of epithelial ingrowth based on the experimental and clinico-histopathological studies performed in collaboration with the University Eye Hospital in Erlangen, Germany and to present own experience with the treatment of epithelial ingrowth by en-block excision of the lesion. Material and methods: five aphakic and pseudophakic patients with epithelial ingrowth were treated in recent years in our department. In 3 patients en-block excision of the entire cystic growth was performed. Remaining 2 patients referred with undiagnosed advanced diffuse growth received only palliative treatment. Results: In 3 patients treated with the lesion excision the eyeball integrity was preserved and some useful vision was maintained after surgery (follow-up 16 months - 9 years). In one patient secondary glaucoma required cyclodestructive procedure and topical medications to control the IOP. In one patient with very fast growing cyst histopathology of the excisate revealed a sub-Descemet growth which seems to be very unusual. Conclusions: In spite of advances in the microsurgical techniques epithelial ingrowth can still occur after intracapsular and extracapsular cataract extraction, even years after surgery and can pose diagnostic difficulties, mainly in its diffuse form. En-block excision seems to be the reliable method of treatment of epithelial ingrowth, especially its cystic form.

Keywords: epithelial ingrowth, cataract surgery, en-block excision

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