In toto extraction of spontaneous conjunctival cysts without incision under slit-lamp microscopic view

Abstract Objective We describe a technique for the in toto extraction of spontaneous conjunctival cysts without incision under slit-lamp microscopic view. Design Interventional case series. Participants Eleven eyes of 11 patients. Methods This was a multicentre study. Selection criterion was symptomatic conjunctival spontaneous cysts. Topical anaesthesia was applied, and the conjunctival cyst was extracted with a 26-gauge × 0.5-inch needle attached to a 1-mL disposable syringe. The bevel of the needle was oriented toward the surgeon, and it was inserted into the conjunctival cyst. The surgeon then pulled the plunger to produce negative pressure and sucked the fluid from the cyst. After the fluid was drained, the negative pressure also sucked the inner walls of the cysts into the needle tip. The surgeon slowly pulled the needle tip from the subconjunctival space. In most cases, a stump of the cyst remained at the entry site; it was grasped with forceps and totally extracted. Results This technique was used on 11 eyes that were followed for 23.2 months. The conjunctival cysts were extracted in toto from all eyes, and a recurrence was observed in 1 eye during the follow-up period. In the 1 eye, a small residual cyst recurred, and it was extracted by the same technique. Conclusions This method of extracting conjunctival cysts is indicated for spontaneous conjunctival cysts that are considered to be free from adhesion to the surrounding tissue. It is an easy and minimally invasive method of extraction under a slit-lamp microscope without incision.