Intracorneal cysts are uncommon lesions that occur either due to congenital or traumatic pathology. Treatments described include cyst excision, drainage or intracyst injection of chemical solutions, such as ethanol. Recurrences commonly occur with these modalities and there is no clear consensus on the best approach to take. In this article, the authors present a rare case of a recurrent intrastromal epithelial corneal cyst following suture removal in an 11-year-old boy who had undergone optical penetrating keratoplasty in his left eye. It was managed effectively with an innovative technique of lamellar excision and donor corneal stromal lenticule lamellar placement to prevent recurrence. Serial postoperative anterior segment optical coherence tomography (ASOCT) was performed to monitor for cyst recurrence. No recurrence was observed for one and a half years with clear corneal graft. ASOCT is an effective tool in the diagnosis and follow-up of a recurrent intrastromal epithelial inclusion cyst.