Krishnacharya Prabhakar Srinivasapuram
Department of Ophthalmology, JSS Hospital, M.G. Road, Mysore, Karnataka 570004, India.
Case Rep Med. 2013;2013:759267. doi: 10.1155/2013/759267. Epub 2013 Nov 21.
Context. Tenon's cyst or conjunctival cyst formation is not uncommon late complication of traditional extracapsular cataract surgery; however, few reports are available in the literature. Aims. Large cystic swellings were clinically diagnosed as filtering blebs at the cataract incision site in two patients. The purpose of the case presentation is to discuss the factors leading to cyst formation, visual loss and cyst recurrence after its excision. Patients and Methods. Case 1. Sixty-one-year-old male patient presented with a bleb at superior limbal region in the right eye, two years after cataract surgery. Case 2. A giant bleb was found at the same region in the right eye of a 65-year-old male patient, eight years after cataract surgery. Results. Complete excision of the cyst was performed with conjunctival autograft in the first patient and followed up for two years. No recurrence of the cyst was observed. Internal wound gaping was seen on gonioscopy in the second patient. Conclusions. Unstable scleral tunnel could explain bleb formation in both the patients. Complete bleb excision with conjunctival auto-graft resulted in closure of the defect with no bleb recurrence during two-year follow-up. Over-filtration causing hypotonic maculopathy was the reason for decreased vision in the second case.
背景。眼球筋膜囊肿或结膜囊肿形成是传统囊外白内障手术不常见的晚期并发症；然而，文献中相关报道较少。目的。两名患者在白内障手术切口部位临床上将大的囊性肿物诊断为滤过泡。本病例报告的目的是探讨囊肿形成、视力丧失及囊肿切除后复发的相关因素。患者与方法。病例1：一名61岁男性患者在白内障手术后两年，右眼上睑缘区出现一个滤过泡。病例2：一名65岁男性患者在白内障手术后八年，右眼同一区域发现一个巨大滤过泡。结果。首例患者行囊肿完整切除并联合结膜自体移植，随访两年，未见囊肿复发。第二例患者房角镜检查发现内部伤口裂开。结论。巩膜隧道不稳定可解释两名患者滤过泡的形成。首例患者行滤过泡完整切除并联合结膜自体移植，在两年随访期间缺损闭合，无滤过泡复发。第二例患者视力下降的原因是过度滤过导致低张性黄斑病变。
