Accessory lacrimal gland duct cyst: 23 years of experience in the Saudi population

• Published in: Annals of Saudi medicine Vol. 35; no. 5; pp. 394 - 399
• Main Authors: Galindo-Ferreiro, Alicia, Alkatan, Hind Manaa, Muinos-Diaz, Yerena, Akaishi, Patricia Mitiko, Galvez-Ruiz, Alberto, Cruz, Augusto Velasco
• Format: Journal Article
• Language: English
• Published: Saudi Arabia KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTRE 01.09.2015; King Faisal Specialist Hospital and Research Centre
• Subjects: Acids; Adult; Brief Report; Conjunctiva - surgery; Corneal Perforation - etiology; Cysts; Cysts - epidemiology; Cysts - pathology; Cysts - surgery; Etiology; Female; Humans; Lacrimal Apparatus - pathology; Lacrimal Apparatus - surgery; Lacrimal Apparatus Diseases - epidemiology; Lacrimal Apparatus Diseases - pathology; Lacrimal Apparatus Diseases - surgery; Male; Ophthalmologic Surgical Procedures - adverse effects; Ophthalmologic Surgical Procedures - methods; Patients; Postoperative Complications - etiology; Prevalence; Retrospective Studies; Rupture; Saudi Arabia - epidemiology; Time Factors; Trachoma - complications; Treatment Outcome; Saudi Arabia
• ISSN: 0256-4947; 0975-4466
• DOI: 10.5144/0256-4947.2015.394

Accessory lacrimal gland ductal cyst is a rare clinical entity that has been reported after trauma, infection, or conjunctival inflammation. Trachoma has been postulated as an etiologic factor for this dacryops in Saudis. We studied the prevalence, demographics, clinicopathological features and surgical approach for these lesions. Retrospective study of 23 consecutive ductal cysts diagnosed clinically and proved histopathologically at King Khaled Eye Specialist Hospital (KKESH) over 23 years (1991-2014). Data on patient demographics, clinical features, surgery, and outcome were collected by chart review. The histopathologic slides were reviewed by a single pathologist. Of 23 cases of accessory lacrimal gland ductal cysts confirmed histopathologically, 14 were males and 9 females with a median age of 38.8 years. Cysts were located in the upper eyelid in 73.9%. The commonest presentation was a painless eyelid mass in 91.3%. Excision by conjunctival incision was performed in 14 and intra-operative perforation occurred in 9. Trachomatous scarring was evident in 39.1% but did not have significance in relation to this rupture. No recurrences have been observed with a mean follow up of 34.6 months. The approximate prevalence of accessory lacrimal gland dacryops in the Saudi population is 1/6800. Trachoma does not seem to be a major predisposing factor. They are more frequent in males. Their histopathological appearance is identical regardless of origin. The presence of conjunctival scarring, dacryops size, and the surgical incision type did not seem to have significant correlation with the iatrogenic rupture of the cyst. We recommend careful dissection for complete cyst excision through conjunctival approach with no expected recurrence.