Epithelial implantation cysts of the upper eyelid after lid-lowering procedures.

Abstract

Epithelial inclusion cysts are benign lesions that have been described after intraocular and intraorbital surgery or trauma. The authors determine the rate of occurrence and characteristics of epithelial implantation cysts after upper eyelid-lowering procedures using a posterior conjunctival incision. The records of 109 upper eyelid-lowering cases over a 9-year period that had an internal incision were reviewed retrospectively. Any cysts removed were sent for histopathologic examination. The incidence of cyst development was found to be 2.75%. The cysts were small and remained under 4 mm over time. Histopathologic findings of the two epithelial cysts removed suggested a conjunctival origin. The development of cysts did not correlate with length and difficulty of the procedure. Epithelial implantation cysts of the eyelid after posterior approach levator recession procedures are rare (2.75% incidence). However, they often require surgical excision due to their conspicuous location. Their origin is probably the conjunctival epithelium implanted while manipulating the conjunctival incision edge.