Giant Secondary Conjunctival Inclusion Cysts. A Late Complication of Strabismus Surgery

Purpose: To present giant conjunctival inclusion cysts as a late complication of strabismus surgery. Design: Retrospective case series of selected patients. Participants: Four patients with a history of strabismus surgery who had developed giant conjunctival inclusion cysts. Methods: A chart review was performed. The patient's ocular history, ophthalmic examinations, and imaging (ultrasound/ultrasound biomicroscopy and/or computed tomography) were recorded. Surgical excision with subsequent histopathologic correlation was obtained in 3 cases. Main Outcome Measures: Clinical and imaging characteristics with histopathologic correlation. Results: Four patients with giant conjunctival inclusion cysts had a history of strabismus surgery. Ultrasound biomicroscopy was performed in 3 cases and revealed large, cystic, well-circumscribed tumors with low internal reflectivity and hyperechoic components. Computed tomography of the orbits was used to evaluate posterior extension. Their size induced limitation in motility, strabismus, and problems related to chronic exposure. Histopathologic evaluations were consistent with benign inclusion cysts of the conjunctiva. Conclusions: Giant conjunctival inclusion cysts may appear decades after strabismus surgery. Tumor size, cystic nature, and involvement of underlying structures can be determined by ultrasonography and radiographic imaging. Complete surgical removal can be curative.