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Partial Lamellar Sclerokeratouvectomy for Management of Epithelial Downgrowth

Purpose: To describe a method of surgical management for cases of localized epithelial downgrowth (EDG). Methods: Single-center retrospective chart review of patients with histologically confirmed localized EDG of stratified squamous epithelium. Each patient underwent a partial lamellar sclerokeratouvectomy encompassing the area of suspected EDG. The main outcome measure was recurrence of EDG. Results: At a mean of 51 months of postoperative follow-up (range: 31–86), no patient had evidence of recurrent EDG. One eye developed worsening of preexisting glaucoma. All 3 eyes developed localized corneal edema, but only 1 required corneal transplantation. Conclusions: EDG is a potentially devastating complication of intraocular surgery or penetrating injury. In cases of localized involvement of the anterior chamber structures, definitive management of EDG can be achieved via resection of the involved scleral, corneal, and uveal tissue. A lamellar approach minimizes tissue loss and maintains a structurally sound, pressurized globe.