Results of excision of advanced epithelial downgrowth

Advanced epithelial downgrowth was excised in 14 patients. The technique involved excision under direct observation of the epithelium found as bands in the anterior chamber and as membranes in the front and back of the iris, over the ciliary body, on the front and back surfaces of intraocular lenses, and over the vitreous face. In the first nine cases, cryoapplication was used to destroy the epithelium on the back of the cornea. In three patients, in spite of repeated applications, the epithelium was unaffected by freezing. In these cases the epithelial downgrowth was excised by scraping it free from the back of the cornea. In four eyes the whole cornea was removed both for visualization of the extent of the growth of the epithelium throughout the anterior and posterior chamber and to scrape the epithelium free. Thereafter the cornea was replaced. Eleven of the 14 eyes have remained free of epithelial downgrowth from 18 months to eight years postoperatively. Penetrating corneal transplantations were performed in six eyes because of corneal edema; these have remained transparent. Although two eyes have vision better than 20/40, the majority have 20/200.