Superficial corneal epithelial inclusion cysts treated by simple lancing in 4 dogs

To describe a nonsurgical treatment for superficial corneal epithelial inclusion cysts (CEICs) in dogs and to characterize their clinical and diagnostic features using ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT).

4 client-owned dogs with superficial CEICs.

Complete ophthalmic examinations and diagnostic imaging using UBM and/or OCT were performed on smooth, fluctuant, painless masses protruding from vascularized corneas. For superficial CEICs, needle lancing was performed under topical anesthesia.

All dogs had been previously managed for keratoconjunctivitis sicca. Ultrasound biomicroscopy or OCT revealed superficial intrastromal cystic lesions surrounded by hyperechoic or hyper-reflective stroma, consistent with CEICs. All cysts were located within vascularized corneal stroma, with sufficient posterior stromal thickness and intact Descemet membrane beneath the cysts. Among 6 initially identified cysts, 1 ruptured spontaneously following trauma and was no longer detectable at reexamination. One cyst was excised by superficial keratectomy, and histopathologic examination confirmed CEIC; this cyst subsequently recurred. The remaining 4 cysts were intentionally treated by needle lancing using a 26-gauge needle under topical anesthesia. Cytologic examination of the drained material revealed predominantly extracellular matrix and epithelial cells without evidence of infection, supporting the diagnosis of CEIC. Topical anti-inflammatory agents and antibiotics were prescribed after lancing. None of the lanced cysts recurred during a follow-up period of 17 to 62 months.

Needle lancing may represent a safe, simple, and effective treatment option for superficial vascularized CEICs in dogs. Advanced diagnostic imaging, such as UBM/OCT, may aid in determining cyst depth and guiding treatment selection.