Inclusion cysts after manual small incision cataract surgery: insights into presentation, management and outcomes

We report a series of three patients who developed conjunctival inclusion cysts following manual small incision cataract surgery (MSICS). Presenting symptoms included foreign body sensation and ocular irritation, sometimes mistaken for filtering blebs. Diagnosis was confirmed through slit-lamp examination, ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT). Surgical management varied: two cases underwent complete cyst excision with fluid aspiration, while the third case was managed by aspiration alone. Histopathology consistently confirmed epithelial inclusion cysts. All three patients experienced symptomatic relief and no significant recurrence on follow-up. This case series of conjunctival inclusion cysts as an uncommon complication following MSICS surgery highlights the importance of accurate diagnosis and tailored surgical management.