BUCKLE-ASSOCIATED EPITHELIAL CYST MASQUERADING AS INTRAOCULAR INFLAMMATION

BACKGROUND/PURPOSE: To describe a case of a rare, late scleral buckle-related complication, which was masquerading as ocular inflammation. METHODS: Case report. RESULTS: A 63-year-old woman with ocular history significant for cataract extraction with intraocular lens placement and retinal detachment repaired through pars plana vitrectomy and scleral buckle presents with anterior chamber inflammation and debris in the left eye. Uveitis workup was negative for any associated systemic disease. Anterior chamber washout and biopsy were nondiagnostic. At postoperative Month 1, she had recurrent anterior chamber debris and new debris noted in the vitreous cavity. A pars plana vitrectomy was performed, and during intraoperative scleral depression, copious strands of whitish material were expressed into the vitreous cavity. The scleral buckle was removed with additional whitish material noted within the encapsulated area. Papanicolaou stain of the material demonstrated a mixture of epithelial cells, histiocytes, lymphocytes, plasma cells, and neutrophils consistent with an epithelial cyst. CONCLUSION: Epithelial inclusion cysts are a rare complication of scleral buckle placement. These cysts are lined by a nonkeratinized, stratified squamous epithelium with or without goblet cells and most commonly occur after ocular trauma, inflammation, or surgical procedures. To the best of our knowledge, this is the first reported case of erosion of an epithelial inclusion cyst into the vitreous cavity.