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

Needle lancing under topical anesthesia is a safe, effective treatment for superficial corneal epithelial inclusion cysts in dogs.

This study describes a minimally invasive, nonsurgical approach for managing superficial corneal epithelial inclusion cysts (CEICs) in dogs, with concurrent characterization of their clinical and imaging features using ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT). Four client-owned dogs, all with a history of keratoconjunctivitis sicca (KCS), presented with smooth, fluctuant, painless corneal masses arising from vascularized stroma. Advanced imaging confirmed superficial intrastromal cystic lesions with intact Descemet membranes and adequate posterior stromal thickness, making them amenable to conservative treatment. Of 6 identified cysts, one ruptured spontaneously after trauma, one was managed via superficial keratectomy (confirmed histopathologically as CEIC but subsequently recurred), and four were treated by needle lancing using a 26-gauge needle under topical anesthesia. Cytologic analysis of aspirated material revealed extracellular matrix and epithelial cells without infectious organisms, supporting the CEIC diagnosis. Post-lancing treatment included topical anti-inflammatory agents and antibiotics. Importantly, none of the four lanced cysts recurred over a follow-up period of 17 to 62 months. The association of CEICs with KCS and corneal vascularization suggests chronic ocular surface disease may be a predisposing factor. This report highlights that UBM and OCT are valuable tools for assessing cyst depth and guiding treatment selection. Needle lancing appears to be a safe, effective, and cost-efficient alternative to surgical keratectomy for superficial vascularized CEICs in dogs.

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