Fornix reconstruction with conjunctival inclusion cyst marsupialization in Stevens-Johnson syndrome

A 17-year-old boy presented with multiple, progressively enlarging cystic masses located at the junction of the lower eyelids and anterior orbit, 1 year after recovery from Stevens-Johnson syndrome. Bilaterally, symblepharon obliterated the inferior fornix and restricted supraduction. All but 1 cyst (which was sent for microscopic evaluation) was marsupialized. Cut edges of the cysts were sutured to adjacent conjunctiva and the epithelial walls were used as fornix lining. Histologically, the wall of the excised cyst consisted of conjunctiva. One year after surgery, the inferior fornices remained substantially deepened with improved ocular motility. This case demonstrated that conjunctival inclusion cysts occurring in the aftermath of Stevens-Johnson syndrome can be effectively managed with marsupialization. The epithelial lining can then be used in fornix reconstruction.