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Epithelial Downgrowth

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Abstract

Epithelial downgrowth is a disastrous complication of ocular surgery or trauma in which corneal or conjunctival epithelium invades the anterior chamber and other intraocular structures. The epithelial growth patterns are categorized as diffuse or cystic growth, with diffuse growth being up to four times more common and occurring more frequently after trauma. The current incidence of epithelial downgrowth is difficult to determine. Previous literature has cited cataract surgery as the most common cause with an incidence of 0% to 0.076% and up to 1.1%. Most authors agree the incidence of epithelial downgrowth has decreased secondary to improvements in surgical technique, instrumentation, and suture material. Other surgical procedures cited as predisposing to epithelial downgrowth are listed in Table 74.1. The time to onset is highly variable and dependent on etiology. For example, epithelial downgrowth following cataract surgery has been reported 4 days to 56 years into the postoperative period, with a mean onset of presentation ranging from 5 months to 10 months. In one study, epithelial downgrowth occurred 4-7 months following penetrating keratoplasty. Glaucoma is variably present in patients with epithelial downgrowth. In Küchle and Green’s review of 207 histopathologically proven cases, they reported a rate of glaucoma of 43.1%.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Summa Health Systems, Akron, OH, USA

    Matthew C. Willett MD

  2. Department of Glaucoma Services, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia

    Sami Al-Shahwan MD

  3. Department of Ophthalmology, Northeastern Ohio Universities College of Medicine, Summa Health Systems, Akron, OH, USA

    Deepak P. Edward MD, FACS

Authors
  1. Matthew C. Willett MD
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  2. Sami Al-Shahwan MD
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  3. Deepak P. Edward MD, FACS
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Editor information

Editors and Affiliations

  1. 2889 10th Avenue, N., Palm Springs, 33461, USA

    Paul N. Schacknow

  2. Casey Eye Institute, Dept. Ophthalmology, Oregon Health & Sciences University, SW. Terwilliger Blvd. 3375, Portland, 97201-4197, USA

    John R. Samples

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Willett, M.C., Al-Shahwan, S., Edward, D.P. (2010). Epithelial Downgrowth. In: Schacknow, P., Samples, J. (eds) The Glaucoma Book. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76700-0_74

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  • DOI: https://doi.org/10.1007/978-0-387-76700-0_74

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-76699-7

  • Online ISBN: 978-0-387-76700-0

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