Abstract
Two very rare cases of intrastromal keratolimbal epithelial cysts are reported. Firstly,
an enlarging congenital cyst in a 9-year-old boy, and secondly, a recurrent postsurgical
cyst in an
18-year-old female patient. Both cases presented with a limbal cyst, continuing into
the corneal stroma as a whitish mass up to the optical axis. The indication for surgery
was stabilization
of visual acuity in case one and improvement of cosmetic aspects in case two. In the
first case, a small part of the cyst was opened at the limbus and the whitish material
in the cyst was
flushed out. In the second case, anterior lamellar keratectomy over the whole cyst
was performed with subsequent application of mitomycin C. Immunohistochemical analysis
revealed cytokeratin
19-positive epithelial cells in both cysts. Therefore, an implantation of conjunctival
epithelium into the sclera seems to be responsible for the respective keratolimbal
cyst.
Postsurgically, satisfying cosmetic and functional results were obtained in both cases,
with follow-ups of 4 and 9 months. Keratolimbal cysts have rarely been described in
the literature. In
most cases, a conjunctival epithelial implantation occurs following surgery or trauma
and very rarely congenitally. After simple aspiration of the cystʼs content, a rapid
recurrence is often
observed, so that partial or – if possible – complete removal of the anterior cyst
wall is recommended, as shown in our cases.
Key words
corneal cyst - corneal surgery - epithelial implantation
