Block excision of cystic and diffuse epithelial ingrowth of the anterior chamber. Report on 32 consecutive patients
G. O. Naumann and V. Rummelt
Department of Ophthalmology, University of Erlangen-Nurnberg, Germany.
From 1980 to 1990, 32 consecutive patients with progressive cystic or
diffuse epithelial ingrowth of the anterior chamber were treated
successfully with block excision. This technique consists of simultaneous
removal of adjacent iris, pars plicata of ciliary body, and all layers of
sclera and cornea in contact with the lesion acting as a shell. The
resulting defect is covered by a tectonic corneoscleral graft. Twelve
patients had suffered from perforating ocular injury, 10 patients had
previously undergone cataract extraction, and 10 patients had various
causes of epithelial ingrowth. Cystic epithelial ingrowth occurred in 27
patients, diffuse sheetlike epithelial ingrowth occurred in four patients,
and one lesion was identified as foreign body granuloma. On histopathologic
examination, all but two patients revealed epithelial involvement of the
surface of the ciliary body. All patients were followed up for an average
of 60.1 months (range, 1 to 120 months). Long-term visual acuity was better
than 20/60 in 37.5% of the patients. No recurrence of ingrowth was noted
and enucleation was not necessary. Our results indicate that block excision
currently may be the treatment of choice for cystic and diffuse sheetlike
epithelial ingrowth of the anterior chamber.
