Radical anterior segment surgery for epithelial invasion of the anterior chamber: report of three cases.

Abstract

Three patients who developed epithelial invasion of the anterior chamber were treated by radical anterior segment surgery. Two adults had typical epithelial downgrowth of the anterior chamber, while the third patient, an 8-year-old child, developed large serous cysts following evacuation of a traumatic hyphema. In all three patients, the invading epithelium involved the iris, cornea, and angle, while the two adults had epithelium on the vitreous face as well. The operation consisted of an en bloc excision of cornea and sclera with contiguous iris, ciliary body, and vitreous when necessary. A free-hand corneoscleral graft was fashioned and sewn into the bed using interrupted 9-0 nylon sutures on the scleral side and continuous 10-0 nylon sutures on the corneal side. The patients all developed transitory glaucoma in the early post-operative period. The glaucoma was controlled with acetazolamide. A mild anterior uveitis usually was present for several months and was suppressed with topical applications of corticosteroids. Histopathologic study of the excised tissue showed complete removal of the epithelium.