A Case of Conjunctival Cyst Required Removal Six Months After Strabismus Surgery

A conjunctival cyst is a rare yet significant complication following strabismus surgery. This report describes a nine-year-old girl who developed a conjunctival cyst after undergoing bilateral lateral rectus recession surgery for intermittent exotropia. Despite an uneventful surgery and standard postoperative care, she presented with a gradually enlarging subconjunctival mass in the left eye three months later. Initial conservative treatment with topical antibiotics and steroids proved ineffective, leading to surgical excision six months postoperatively. Histopathological examination confirmed the cyst as a conjunctival epithelial inclusion cyst, characterized by cuboidal epithelium containing goblet cells. The patient's postoperative course was uneventful, with no recurrence of the cyst at six months follow-up, stable visual acuity, and maintained strabismus correction. In managing this case, two crucial lessons were learned. Firstly, the need for precise surgical techniques and the use of adequate pre- and intraoperative disinfection measures to prevent postoperative complications. Ensuring that the conjunctival tissue is not inadvertently included in the wound closure and maintaining a sterile environment throughout the surgery are critical steps. Secondly, the importance of early recognition and timely intervention for postoperative complications. The patient's cyst developed three months post-surgery and did not respond to conservative treatments, necessitating surgical excision. This reinforces the need for heightened awareness and prompt surgical intervention when conservative measures fail, ensuring optimal patient outcomes and avoiding unnecessary discomfort or cosmetic issues. In conclusion, meticulous surgical technique and proper pre- and intraoperative disinfection are paramount in preventing postoperative complications such as conjunctival cysts. Early recognition and timely surgical intervention are essential for managing these cysts effectively. This case reinforces the importance for ophthalmic surgeons to remain vigilant in their surgical practices and to promptly address any postoperative complications, thereby improving surgical outcomes and enhancing patient care in strabismus surgery.