Metaplastic squamous epithelial downgrowth after clear corneal cataract surgery.

PURPOSE: To report a case of metaplastic squamous epithelial downgrowth after cataract surgery.

DESIGN

Interventional case report.

METHODS

Clinical, laboratory, and histologic findings are presented. Our study is in compliance with institutional review board guidelines.

RESULTS

A 76-year-old man developed anterior chamber inflammation five months after uncomplicated clear corneal cataract surgery. Despite antimicrobial and anti-inflammatory therapies, the inflammation persisted. An extensive examination failed to demonstrate an infectious etiology or lymphoma. Subsequently, the patient developed an incipient limbal lesion and iris mass. Immunostaining of a biopsy specimen from the iris mass indicated an epithelial-derived tumor. The prephthisical and painful eye was enucleated; histopathology of the globe revealed a contiguous lesion extending from the limbal mass to the iris tumor through the surgical incision site, a finding consistent with metaplastic squamous epithelial downgrowth. Systemic evaluation was negative.

CONCLUSIONS

After intraocular surgery, metaplastic epithelial downgrowth may occur as a consequence of occult ocular surface squamous neoplasia and masquerade as chronic inflammation; clinicians should be aware of this rare complication.