28/05/2024
๐๐ฃ๐๐๐ซ๐๐ง๐ฉ๐๐ฃ๐ฉ ๐พ๐ฎ๐จ๐ฉ๐๐ ๐ฝ๐ก๐๐ ๐๐ค๐ง๐ข๐๐ฉ๐๐ค๐ฃ ๐๐ฃ ๐ ๐ฅ๐ค๐จ๐ฉ-๐ข๐๐ฃ๐ช๐๐ก ๐จ๐ข๐๐ก๐ก ๐๐ฃ๐๐๐จ๐๐ค๐ฃ ๐๐๐ฉ๐๐ง๐๐๐ฉ ๐จ๐ช๐ง๐๐๐ง๐ฎ ๐ฅ๐๐ฉ๐๐๐ฃ๐ฉ
This patient was referred to me because he developed a cystic bleb on the right eye, which has been causing discomfort and foreign body sensation for almost a year. The lesion looked similar to a cystic bleb from a previous glaucoma filtering procedure/ trabeculectomy, however, this patient only had a cataract removal surgery 8 years ago.
On closer inspection, a scleral defect could be noted beneath the cystic bleb providing communication between the cyst and the anterior chamber, while the pupil is corectopic due to parts of it being incarcerated toward the defect.
The cyst was excised, and a scleral patch graft was performed. Sphincterotomies were done on the inferior pupil border to increase its size.
Inadvertent cystic bleb formation can occur as a complication of manual small incision cataract surgeries, although its incidence has decreased due to the advent of clear corneal phacoemulsification. It can occur possibly from poor wound construction, too large wound or its inadequate closure, as well as scleral thinning from too much use of cautery. Risk for endophthalmitis as well as hypotony have been reported to be higher in these patients so itโs really important to make sure that adequate closure has been achieved with no microleaks before ending your surgery and to regularly check on your patients post-operatively.
Ref: Pawar, Bhargavi; Reddy, Manjoo; Kamath, Sripathi. Postoperative conjunctival cyst: A masquerade. Indian Journal of Ophthalmology 59(5):p 406-407, SepโOct 2011. | DOI: 10.4103/0301-4738.83630
