Long-term results of surgical excision of conjunctival retention cyst using trypan blue with methylcellulose

Abstract

Purpose Conjunctival retention cysts may recur if not completely removed. However, the cyst wall often ruptures during surgical excision, making complete removal difficult. In order to ensure complete cyst excision, we used a method of staining the inner cyst wall using trypan blue augmented by Methyl cellulose. Observation Interventional study. Staining was performed by injecting trypan blue using an insulin needle. Then the needle was kept in place and methyl cellulose was injected to make the cyst content viscous to avoid its collapse after removing the needle. By using this technique, it was possible to excise the lesion as a whole. Three patients were included (unilateral). Two patients had cysts that were secondary to trachoma and were followed for up to 2 years without recurrence. A third patient had a conjunctival cyst following strabismus surgery was not successfully removed. Conclusion This method is simple and effective for complete excision of conjunctival retention cysts exception for cysts post strabismus surgery.

Conjunctival Cyst Excision Using Sodium Hyaluronate and Trypan Blue: A case Report

“…In a different study, methyl cellulose was employed as a viscodispersive to view the cyst and perform a comparable function. Nevertheless, methyl cellulose preserved less space than sodium hyaluronate [6] .…”

“…In ophthalmic surgery, the use of trypan blue [TB] stain is not new [4] . TB was used by other authors for staining of conjunctival cyst before excision with favorable results [6,9] . Other authors have utilized additional stains, such as Indocyanine Green [ICG] to emphasize the visualization of the cyst.…”

<p>A Novel Approach to Treatment of Conjunctival Cyst Ablation Using Atmospheric Low-Temperature Plasma</p>

“…The Conjunctival cyst is a sac-like lesion with a thin wall that contains clear or sometimes turbid fluid. 1,2 This lesion can be congenital or acquired. Congenital cysts can remain hidden in the fornix and gradually increase with age.…”

“…3 Acquired cysts can appear after eye trauma, after surgeries such as strabismus, pterygium, scleral buckling, resulting from conjunctivitis such as trachoma, rarely after medication, or even spontaneously. 1,2,[4][5][6] Most patients with conjunctival cysts are asymptomatic, but others may have symptoms such as mild ocular discomfort, foreign body sensation, corneal astigmatism by compression, dry eye due to unstable tear film, and cosmetic disfigurement, depending on the location and size of the cyst. 3,7 Cysts may remain stable and asymptomatic and rarely resolve spontaneously.…”

“…The treatment for cysts is to remove them completely. So far, different methods have been proposed, including aspiration, 8 excision, 2,8,9 thermal cautery, 4 alcohol injection, 5 argon laser photoablation, 10 YAG laser, 11 high-frequency radiowave electrosurgery 7 and pattern scan laser photocoagulation 12 to remove the conjunctival cyst. The main complication after treatment is recurrence, which may occur due to the lack of complete separation of the cyst and remain its epithelial cells.…”