Abstract
Purpose
To report a new modified method using a mixture of sodium hyaluronate and indocyanine green solution to facilitate the complete removal of a large conjunctival cyst.
Case summary
Two patients with a large conjunctival cyst on the bulbar conjunctiva were treated. In order to achieve complete removal, a mixture of 1% sodium hyaluonate and indocyanine green solution was injected through a 27-G needle into the cyst. The procedure provided excellent visualization of the cyst boundaries while maintaining cyst integrity allowing for an easy and complete resection. Apocrine hidrocystoma and a simple retention cyst were confirmed on histopathologic examination, respectively.
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Figure 1.
(A) 6×5 mm-sized large conjunctival cyst is seen in the bulbar conjunctiva of the right eye.(B) The cyst margin are clearly visible through the conjunctiva after stained with a mixture of sodium hyaluronate and indocyanine green solution. (C, D) Successful removal of the conjunctival cyst with delineated capsule and preserved integrity.
![jkos-52-994f1.tif](/upload/SynapseXML/0035jkos/thumb/jkos-52-994f1.gif)
Figure 2.
Double layered lining of apocrine hidrocytoma (H&E stain, ×40) (A), consisting of large columnar cells with eosinophilic cytoplasm with luminal decapitation secretion in the inner layer and flat myoepithelial cells in the outer layer (H&E stain, ×100).(B) Arrows indicate PAS-positive, diastase-resistant granule on the apical surfaces of the inner layer (PAS stain, ×100).
![jkos-52-994f2.tif](/upload/SynapseXML/0035jkos/thumb/jkos-52-994f2.gif)
Figure 3.
(A) 6×4 mm-sized large conjunctival cyst is seen in the medial conjunctiva adjacent to the caruncle of the right eye. (B) The cyst is stained using a mixture of sodium hyaluronate and indocyanine green solution. (C) Succesful removal of the conjunctival cyst with delineated capsule and preserved integrity. (D) A solitary uniocular cyst is lined by non-keratinizing cuboidal epithelium. Goblet cells are often included (H&E stain, ×20).
![jkos-52-994f3.tif](/upload/SynapseXML/0035jkos/thumb/jkos-52-994f3.gif)