Intracorneal epithelial ingrowth following sutureless clear corneal cataract surgery

To report an unusual case and long-term follow-up of isolated intracorneal epithelial ingrowth following sutureless, clear corneal cataract surgery.

A 77-year-old patient was first noted to have a deep corneal opacity in an eye 19 months following uncomplicated sutureless clear corneal cataract surgery. From then on, the lesion was seen to become denser and the patient was referred for corneal consultation. Uncorrected visual acuity in the eye measured 20/25. Slit lamp examination found a 1.4 × 1.7 mm whitish lesion located in the pre-Descemet's space. The lesion began at the anterior edge of the cataract incision and extended centrally. The lesion was observed over a 10-year period.

After first noticing the opacity 19 months after cataract surgery, it took an additional 16 months for the lesion to start to regress clinically. At no time was the visual acuity adversely affected. Ultimately, the lesion resolved to a mild deep scar over a 10-year observation period.

An isolated peripheral island of epithelium in the Pre-Descemet's space can be safely observed without intervention as long as it does not affect visual acuity.