Management of Intracorneal Epithelial Cysts With Ethanol Irrigation and Cyst Wall Excision

Abstract

The clinical and pathologic characteristics and the surgical treatment of 2 patients with intrastromal corneal epithelial cysts are described. This interventional case report presents 2 young patients with decreased vision and cosmetic impairment caused by intracorneal epithelial cysts. The first patient had history of strabismus surgery, and the second patient had undergone corneal laceration repair. The cysts had enlarged gradually and dissected into the cornea, threatening the visual axis. Both patients were treated with drainage of cyst contents, chemical cytodestruction with 96% ethanol for 1 minute in a closed system, followed by cyst wall excision. Corneal clarity and appearance improved significantly after surgery. In the first patient, best-corrected visual acuity was 20/20 before the operation and remained stable. In the second patient, best-corrected visual acuity improved from 20/400 to 20/60 after the procedure. Histopathologic findings revealed that the cyst walls were composed of nonkeratinized stratified squamous epithelium. No recurrence was noted up to 8 and 3 months in the first and second patients, respectively. No complication occurred during the follow-up period. Intracorneal epithelial cysts may be treated safely and effectively with a combination of drainage of cyst contents, irrigation with 96% ethanol, and cyst wall excision with good visual and cosmetic results.