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Research Letter
Dec 2012

Epithelial Downgrowth: An Atypical Clinicopathological Case Report

Author Affiliations

Author Affiliations: University of Rochester School of Medicine and Dentistry (Ms Venkateswaran) and Department of Pathology and Laboratory Medicine (Dr Yeaney) and Flaum Eye Institute (Dr Hindman), University of Rochester School of Medicine and Dentistry, Rochester, New York.

Arch Ophthalmol. 2012;130(12):1613-1615. doi:10.1001/archophthalmol.2012.2475

Epithelial downgrowth is a rare but grave complication of intraocular surgery1,2 that typically manifests as epithelial sheets, cysts, or pearls.1-4 Prognosis is poor as incursion of epithelial cells onto anterior chamber structures can result in corneal decompensation, refractory glaucoma, and visual deficits.2 Treatment options include enucleation, surgical excision, irradiation, cryotherapy, cautery, laser coagulation, vitrectomy, and injections of antimetabolites.1-5 Herein, we describe a case in which epithelial downgrowth appeared as an amorphous anterior chamber cellular aggregate, was diagnosed by anterior chamber tap and specular microscopy, and was treated successfully with fluorouracil.

A 66-year-old woman who had been receiving subconjunctival steroid injections for presumed graft rejection visited in December 2009 with decreased vision in her right eye. Her ocular history included Fuchs endothelial dystrophy and narrow-angle glaucoma. Her right eye had undergone penetrating keratoplasty, cataract extraction, and anterior chamber intraocular lens implantation in November 2006 and pars plana vitrectomy and pars plana Ahmed tube shunt in October 2008.

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