Features, treatment and prevention of conjunctival inclusion cysts
Reviewed by Fiona Rowe

Conjunctival inclusion cyst is a rare complication of strabismus surgery and generally develops at the point of muscle reattachment, caused by implantation of conjunctival epithelium. The authors aimed to determine the rate of its development after strabismus surgery and consider preventative options. This was a retrospective review of 4026 eyes of 2662 patients having strabismus surgery from 2015–2021 in a single centre in Turkey. Eleven eyes of 11 patients developed postoperative conjunctival cyst. Mean age was 15.66 ±11.81 years; four were female. Diagnosis was made from 20 days to eight months; mean 42.57 ±61.11 days. All symptomatic patients had had horizontal surgery and two also had oblique and vertical muscle surgery. For 10 patients, this was their first surgery. Ten patients were operated by the resident. Seven were nasal and four were temporal locations. Three patients complained of cosmesis concerns, three with redness, one with foreign body sensation and four with a combination. After one month of topical treatment, four resolved. Seven required surgical excision with an aim to remove an intact and complete cyst to prevent recurrence. Histology confirmed the conjunctival cyst. In this study, incidence was calculated as 0.27%. The authors conclude that these cysts are more likely to be seen after recession and surgery by residents. Preventative measures include proper closure of conjunctiva, attention to personal hygiene, and avoidance of excessive operating periods.

How to reduce conjunctival cyst formation after strabismus surgery?
Huseyinhan Z, Gurez C, Ulgen Y.
STRABISMUS
2023;31(3):166–71.