Successful treatment of an unusually large corneal epithelial inclusion cyst using equine amniotic membrane in a dog

Abstract

A 10-year-old intact male Yorkshire Terrier was referred for investigation of a large raised and nonpainful corneal lesion oculus dexter. Clinical examination revealed a pale, translucent corneal mass, which occupied half of the corneal surface and measured 11 mm x 11 mm x 13 mm. The mass was removed by superficial keratectomy and equine amniotic membrane (AM) was transplanted into the large corneal defect to cover the wound and provide tectonic support for the remaining cornea. The mass was histologically confirmed as a corneal epithelial inclusion cyst. There was no evidence of recurrence or complication at the surgical site 100 days postoperatively. Corneal epithelial inclusion cysts are uncommon in dogs. Although superficial keratectomy is the recommended treatment for corneal inclusion cyst, the combination of superficial keratectomy and AM transplantation had to be considered as an alternative for repair of large corneal defects. This is the first case report of the combined application of AM and superficial keratectomy to successfully treat a corneal inclusion cyst in a dog.

Clinical and diagnostic evaluation of intraocular expulsion of a corneal epithelial inclusion cyst in a dog

“…The lesions are formed by corneal epithelium becoming disorganized and displaced into the corneal stroma most commonly as a result of trauma . Following displacement, the epithelium will proliferate and continuously deposit desquamated cells into the center of the cyst . These eye lesions have been previously reported in dogs, humans, llama, red deer, and a cat .…”

“…Following displacement, the epithelium will proliferate and continuously deposit desquamated cells into the center of the cyst . These eye lesions have been previously reported in dogs, humans, llama, red deer, and a cat . The inciting cause can be trauma, previous corneal surgery, or these cysts can be congenital lesions .…”

“…These eye lesions have been previously reported in dogs, humans, llama, red deer, and a cat . The inciting cause can be trauma, previous corneal surgery, or these cysts can be congenital lesions . Affected eyes are typically comfortable with minimal associated keratitis, but vision can be impaired by the size and location of the cyst .…”

“…Affected eyes are typically comfortable with minimal associated keratitis, but vision can be impaired by the size and location of the cyst . Surgical excision via keratectomy has been previously reported to successfully treat these corneal lesions with some cases requiring various additional grafting procedures including equine amniotic membrane, conjunctiva, and third eyelid flap . Diagnosis is confirmed using light microscopy to identify a nonkeratinized stratified squamous epithelium lining of a fluid‐filled structure .…”

Cactus‐induced keratoconjunctivitis in Texas: A case series of three dogs and one cat

“…Confocal microscopy seemed to demonstrate ongoing epithelial cell maturation within intrastromal tracts; however, the cornea did not seem to display features consistent with epithelial inclusion cyst formation or intraocular penetration of epithelial cells. Epithelial downgrowth and epithelial inclusion cysts are both rare and have been reported to occur spontaneously, or following penetrating injury or surgical manipulation of the cornea in humans and animals . Epithelial inclusion cysts are most often clinically benign, forming raised yellow/tan nonpainful nodules on the ocular surface, most often located in the superior‐temporal cornea.…”