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Antonio Bermudez, Maria Paula Fernandez, Richard K Parrish, Sander R Dubovy; Conjunctival cyst in the setting of Baerveldt glaucoma implant: Clinicopathologic correlation of three cases.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2668.
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To describe the clinicopathologic features of conjunctival inclusion cysts that may occur in the setting of placement of a Baerveldt glaucoma implant.
In a non-comparative, consecutive case series the surgical specimens, clinical photographs and medical records of patients who were diagnosed with epithelial conjunctival cysts in the setting of glaucoma filtration implant surgery were reviewed. The term conjunctival cyst and glaucoma implant were searched in the case file database of the Florida Lions Ocular Pathology Laboratory from 1998 to 2014. Light microscopic examination of formalin fixed, paraffin embedded and hematoxylin and eosin stained slides was performed. The medical records and digital slit lamp photographs were obtained and reviewed.
A total of 3 patients with demonstrated epithelial conjunctival cysts after Baerveldt glaucoma implant were included. Pathologic examination demonstratedcysts lined by goblet cell containing mucosal epithelium. All 3 cysts were located anterior to the implant filtration plate, and in contrast to Tenon's capsule these cysts were thin walled with scant vascularity. All 3 patients were female, had left eye involvement and the age of onset ranged from 52 to 67 years. The preoperative diagnoses were primary open angle glaucoma, irido-corneal endothelial syndrome and chronic angle closure glaucoma. Clinically, the 3 cases presented with foreign body sensation and ocular irritation. Excision of the inclusion cysts resolved foreign body sensation and did not affect intraocular pressure control. No recurrences have been observed on follow-up.
Conjunctival epithelial cysts that develop after glaucoma drainage implant surgery should be differentiated from the thick walled fibrovascular capsule that forms overlying the glaucoma filtration device. If indicated, en-bloc cyst excision may be performed without entering the filtering bleb that is associated with the drainage implant.
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