J Korean Ophthalmol Soc.  2011 Aug;52(8):994-998. 10.3341/jkos.2011.52.8.994.

Successful Removal of Apocrinehydrocytoma Using Indocyanine Green and Sodium Hyaluronate

• Kim B
• Kang NY

• KMID: 2214780
• DOI: http://doi.org/10.3341/jkos.2011.52.8.994

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.
CONCLUSIONS
During the removal of a large cyst, injecting a mixture of sodium hyaluronate and indocyanine green is effective in delineating the cyst capsule while preserving its integrity, thus aiding in the complete removal of the cyst wall.

Keyword

Conjunctival cyst; Indocyanine green; Sodium hyaluronate

MeSH Terms

Conjunctiva
Hidrocystoma
Humans
Hyaluronic Acid
Indocyanine Green
Needles
Retention (Psychology)
Sodium
Hyaluronic Acid
Indocyanine Green
Sodium

Figure

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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.

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  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).

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  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).

Reference

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