1Bangert A., 1,2Bialasiewicz A. A.

1Universitäts-Augenklinik Eppendorf, Hamburg; 2Department of Ophthalmology, SQUH University of Oman, Al Khod/Muscat

Objective: Epithelial downgrowth with its bad prognosis may be preventable with respect to understanding its etiology.
Methods: In 1986-2000 wurde bei 16 eine z Cystic or diffuse epithelial invasion was documented by histopathologic and clinical files in 16 cases durgin 1986-2000. Stains were preformed by PAS, Alcian blue, monoclonal mouse anti-human cytokeratins 10/13, 19 and AE1/AE3.
Results: Evaluable histories of 13 patients ranging from 21-79 years (mean 39 years) showed 7x penetrating injuries, 5x surgical interventions, and 1x undefined. A cystic epithelial invasion was present in 12/16 eyes, in 4/16 a diffuse one. Histological work-up proved the epithelial origin by antihuman cytokeratins 10/13, 19 and AE1/AE3 (AE1/AE3) in 15/16 cases, and PAS (4x positive) and Alcian blue (6x positive) mucin secretion of implanted goblet cells. Therapy consisted of surgical removal (15x), a conjunctival excision 6x, iridectomy 1x, blockexcicion 4x, keratoplasty 2x, enucleation 2x. 1x no surgery was done. Postoperative follow-up was 0-43 (mean 9) months. Postoperative VA was >0.5 in 9/15, <0.1 in 4/15 patients, and anophthalmus in 2/15.
Conclusions: Prevention of epithelial implantation by an adequate primary surgery of penetrating injuries and accurate extra- and intraocular elective procedures is an important prerequisite to circumvent further surgery and an unforseeable outcome.

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