Conjunctival inclusion cysts following small incision cataract surgery.
Bottom Line: Both were treated by excision and confirmed histopathologically.No recurrence was noted at three months follow-up.Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.
Affiliation: Minto Ophthalmic Hospital, Bangalore, India.
The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS) in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.
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Mentions: A 67-year-old man came with complaint of a swelling in his Right Eye (RE) noticed since two months, initially smaller in size, gradually increased to present size and associated with foreign body sensation. He had undergone manual SICS with PCIOL implantation in RE eight months ago. On examination, RE had a BCVA of 20/60, and was pseudophakic with PCIOL. A solitary oval cystic swelling was present at the superior limbus in RE, measuring 11 mm × 9 mm, and containing clear fluid [Fig. 2A]. The LE had a BCVA of counting fingers 4 meters, with posterior subcapsular cataract. The anterior segment and fundus examination were unremarkable. He was posted for surgical excision of the cyst under topical anesthesia. The conjunctiva overlying the cyst was separated by blunt dissection, the cyst was excised at the base, but as with the previous case it ruptured during excision. The underlying sclera was cauterized. The conjunctiva was re-approximated to the limbus by a subconjunctival injection of 0.5 ml gentamicin. The excised cyst was subjected to histopathological examination, which revealed a cyst lined by non-keratinized stratified squamous epithelium showing occasional apical snouts [Fig. 2B], again suggestive of conjunctival inclusion cyst. He also has been followed up for three months without any signs of recurrence.