Motility Disturbance Due to True Tenon Cyst in a Child With a Baerveldt Glaucoma Drainage Implant

Abstract

pithelial ingrowth of the bleb cavity, a true Tenon cyst, is a rare complication of a glaucoma drainage implant. Previous cases have been associated with persistent bleb leak, and most have occurred in eyes with prior extraocular surgery. We describe a case of a true Tenon cyst causing strabismus and an elevated intraocular pressure that was successfully treated by surgical revision.

Tube shunt complications and their prevention

“…This has been reported with other implants as well and is mostly of cosmetic concern if there is not concomitant diplopia [31][32][33].…”

Management of a recurrent encapsulated bleb with a cost-effective non-valved glaucoma drainage device

“…Tenon’s cyst is a relatively uncommon complication and results from extensive epithelial in-growth into the bleb cavity with thickened bleb walls increasing resistance to aqueous outflow, resulting in high IOP and increased bleb height. Tenon’s cyst has an epithelial-lined fluid-filled cavity whereas an encapsulated bleb has a fluid-filled cavity with the sclera and tense Tenon connective tissue comprising the inner wall of the cavity 8. Tenon’s cysts are usually reported in eyes with scleral buckling or squint surgery due to improper initial conjunctival closure before GDD implantation, which may provide both, the nidus, and the stimulus for the epithelial proliferation 9.…”

Late-onset proptosis with Baerveldt glaucoma implants

“…While the previous cases had encapsulation of the plate, the current cases contained diffuse, pink hyperaemic thickening of the tissue surrounding the BGI, which caused concern for co-existing pathology. Another cause may be an implantation epithelial cyst3 but this was not seen on histopathology or on imaging. We speculate that the cause of the proptosis in both cases appeared to be soft-tissue thickening secondary to low-grade inflammation and fibrous tissue formation.…”