Metaplastic squamous epithelial downgrowth after clear corneal cataract surgery

Area of Science:

• Ophthalmology
• Surgical Pathology

Background:

• Cataract surgery is a common intraocular procedure.
• Postoperative inflammation requires careful diagnosis and management.

Observation:

• A 76-year-old male presented with persistent anterior chamber inflammation five months after uncomplicated cataract surgery.
• Initial treatments for infection and lymphoma were unsuccessful.
• The patient developed a limbal lesion and iris mass, with biopsy confirming an epithelial-derived tumor.

Findings:

• Histopathology revealed metaplastic squamous epithelial downgrowth extending from the limbus to the iris through the surgical incision.
• The condition presented as a contiguous lesion involving the ocular surface and anterior chamber.
• Systemic evaluation did not reveal any underlying malignancy.

Implications:

• Metaplastic epithelial downgrowth can occur after intraocular surgery, potentially arising from occult ocular surface squamous neoplasia.
• This rare complication may initially present as chronic ocular inflammation, challenging diagnosis.
• Ophthalmologists should maintain a high index of suspicion for epithelial downgrowth in persistent postoperative inflammation.