Background: Epithelial invasion is a rare but severe complication after penetrating eye trauma or intraocular surgery. Cystic ingrowth can occur even after decades.
Casuistics: A 53-year-old woman developed two epithelial cysts in the left eye 48 years after penetrating trauma with a dart. After primary wound closure the intraocular status remained stable for 48 years before symptoms appeared. Preoperative diagnostics (e.g. ultrasound biomicroscopy) detected the origin of the epithelial downgrowth from an intracorneal cyst. Histology confirmed the clinical suspicion of a cystic epithelial ingrowth.
Conclusion: The latency of our case is the longest reported interval between penetrating eye trauma and appearance of epithelial ingrowth to be described in detail. Ultrasound biomicroscopy is able to detect the origin of epithelial ingrowth.