Management of Epithelial Cysts and Ingrowth

  • Walter J. Stark
  • Peter A. Rapoza
  • Arlo C. Terry
  • M. Bowes Hamill
  • John D. Gottsch
  • Ronald G. Michels
Conference paper
Part of the FIDIA Research Series book series (FIDIA, volume 2)


Epithelial invasion of the anterior chamber is a rare, but often devastating complication of penetrating ocular trauma and anterior segment surgery. In 1830, MacKenzie reported the presence of a semitransparent cyst in the anterior chamber of an eye following trauma. Rothmund, in 1872, speculated that implantation of epithelium at the time of surgery or penetrating trauma resulted in the development of anterior chamber cysts. Collins and Cross (1892) presented the initial description of the histopathology of epithelial cysts in eyes enucleated following cataract surgery. The cysts they observed were lined by laminated epithelium similar to that of the cornea. Pupillary block glaucoma was noted in one of the eyes. During 1937, Perera proposed a classification of epithelial invasion dividing it into three types of lesions: 1) “pearl” tumors of the iris, 2) post-traumatic cysts of the iris (epithelial cysts), and 3) epithelization of the anterior chamber (epithelial ingrowth).


Anterior Chamber Cystoid Macular Edema Corneal Edema Secondary Glaucoma Epithelial Cyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Bernardino VB, Kim JC, and Smith TR (1969): Epithelization of the anterior chamber after cataract extraction. Arch Ophth 82:742–750.CrossRefGoogle Scholar
  2. 2.
    Bettman JW, Jr (1969): Pathology of complications of intraocular surgery. Am J Ophth 68:1037–1050.PubMedGoogle Scholar
  3. 3.
    Brown SI (1973): Treatment of advanced epithelial downgrowth. Tr Am Acad Oph 77:618–622.Google Scholar
  4. 4.
    Bruner WE, Michels RG, Stark WJ, and Maumenee AE (1981): Management of epithelial cysts of the anterior chamber. Ophth Surg 12:279–285.Google Scholar
  5. 5.
    Calhoun FP, Jr (1949): The clinical recognition and treatment of epithelization of the anterior chamber following cataract extraction. Tr Am Oph Soc 47:498–553.Google Scholar
  6. 6.
    Christensen L (1960): Epithelization of the anterior chamber. Tr Am Ophthal Soc 58:294–300.Google Scholar
  7. 7.
    Cleasby GW (1971): Photocoagulation or iris-ciliary body epithelial cysts. Trans Am Acad Oph Oto 75:638–642.Google Scholar
  8. 8.
    Cogan DG (1955): Experimental implants of conjunctiva into the anterior chamber. Am J Ophth 39:165–172.PubMedGoogle Scholar
  9. 9.
    Collins ET, and Cross FR (1982): Two cases of epithelial implantation cyst in the anterior chamber after extraction of cataract. Trans Oph Soc UK. 12:175–180.Google Scholar
  10. 10.
    Dunnington JH (1951): Healing of incision for cataract extraction Am J Ophth 34:36–45.Google Scholar
  11. 11.
    Eiferman RA, and Rodrigues MM (1981): Squamous epithelial implantation cyst of the iris. Ophthalmol 86:1281–1285.Google Scholar
  12. 12.
    Eldrup-Jorgensen P (1969): Epithelization of the anterior chamber. A clinical and histological study of a Danish material. Acta Ophth 47:328–338, 1969.CrossRefGoogle Scholar
  13. 13.
    Ferry AP (1971): The possible role of epithelium-bearing surgical instruments in the pathogenesis of epithelization of the anterior chamber. Annals of Ophthalmol 3:1089–1093.Google Scholar
  14. 14.
    Ferry AP, and Naghdi MR (1967): Cryosurgical removal of epithelial cyst or iris and anterior chamber. Arch Ophth 77:86–87.CrossRefGoogle Scholar
  15. 15.
    Friedman AH (1977): Radical anterior segment surgery for epithelial invasion of the anterior chamber: Report of three cases. Tr Am Acad Oph Oto 83:216–223.Google Scholar
  16. 16.
    Jensen P, Minckler DS, and Chandler JW (1977): Epithelial ingrowth. Arch Ophth 95:837–842.CrossRefGoogle Scholar
  17. 17.
    Gundersen T (1938): Results of autotransplantation of cornea into the anterior chamber: Their significance regarding corneal nutrition. Trans Am Oph Soc 6:207–212.Google Scholar
  18. 18.
    Hogan MJ, and Goodner EK (1960): Surgical treatment of epithelial cysts of the anterior chamber. Arch Ophth 64:286–291.CrossRefGoogle Scholar
  19. 19.
    MacKenzie W (1830): A practical treatise on disease of the eye. Longman, Rees, Orme, Brown, and Green. London.Google Scholar
  20. 20.
    Maumenee AE (1957): Symposium. Postoperative cataract complications. Epithelial invasion of the anterior chamber, retinal detachment, corneal edema, anterior chamber hemorrhages, changes in the macula. Trans Am Acad Oph Oto, 61:51–68.Google Scholar
  21. 21.
    Maumenee AE (1964): Treatment of epithelial downgrowth and intraocular fistula following cataract surgery. Tr Am Oph Soc 62:153–166.Google Scholar
  22. 22.
    Maumenee AE (1968): Complications of cataract surgery. Highlights of Ophth 11:120–132.Google Scholar
  23. 23.
    Maumenee AE, Paton D, Morse PH, and Butner R (1970): Review of 40 histologically proven cases of epithelial downgrowth following cataract extraction and suggested surgical management. Am J Ophth 69:598–603.PubMedGoogle Scholar
  24. 24.
    Maumenee AE, and Shannon CR (1956): Epithelial invasion of the anterior chamber. Am J Ophth 11:929–942.Google Scholar
  25. 25.
    Michels RG, and Rice TR (1977): Internal-external bimanual bipolar diathermy for treatment of bleeding from the anterior chamber angle. Am J Ophth 83:873.Google Scholar
  26. 26.
    Okun E and Mandell E (1974): Photocoagulation as treatment of epithelial implantation cysts following cataract surgery. Tr Am Ophth Soc 72:170–183.PubMedGoogle Scholar
  27. 27.
    Perera CA (1937): Epithelium in the anterior chamber of the eye after operation and injury. Trans Am Soc Oph Oto 42:142–164.Google Scholar
  28. 28.
    Pincus MH (1950): Epithelial invasion of anterior chamber following cataract extraction: Effect of radiation therapy. Arch Ophth 43:509–519.CrossRefGoogle Scholar
  29. 29.
    Regan EF (1958): Epithelial invasion of the anterior chamber. Arch Ophth 60:907–927.CrossRefGoogle Scholar
  30. 30.
    Rothmund A (1872): Ueber cystern der regenbogenhaut, Klin Mbl Augenheilk 10:189–223.Google Scholar
  31. 31.
    Stark WJ (1981): Management of epithelial ingrowth and cysts. Dev. Ophth 5:64–73.Google Scholar
  32. 32.
    Stark WJ, and Bruner WE (1982): Epithelial ingrowth and fibrous proliferations. In: The Secondary Glaucomas, edited by Ritch R and Shields HB, CV Mosby Co, St Louis.Google Scholar
  33. 33.
    Stark WJ, Michels RG, Maumenee AE, and Cupples H (1978): Surgical Management of epithelial ingrowth. Am J Ophth 85:772–780PubMedGoogle Scholar
  34. 34.
    Sugar H (1967): Further experience with posterior lamellar resection of the cornea for epithelial implantation cyst. Am J Ophth 64:291–299.PubMedGoogle Scholar
  35. 35.
    Theobald GD, and Hass JS (1948): Epithelial invasion of the anterior chamber following cataract extraction. Trans Am Acad Oph Oto 52:470–485.Google Scholar
  36. 36.
    Vail D (1936): Epithelial overgrowth into the anterior chamber following cataract extraction: Arrest by radium treatment. Arch Ophth 15:270–282.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • Walter J. Stark
    • 1
  • Peter A. Rapoza
    • 1
  • Arlo C. Terry
    • 1
  • M. Bowes Hamill
    • 1
  • John D. Gottsch
    • 1
  • Ronald G. Michels
    • 1
  1. 1.The Wilmer Ophthalmological InstituteThe Johns Hopkins HospitalBaltimoreUSA

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