Liquid Nitrogen Cryotherapy for Conjunctival Lymphangiectasia: A Case Series

Dec 2009 - Just released

Frederick W. Fraunfelder, MD^*

^Abstract

Purpose:

To report a case series of conjunctival lymphangiectasia treated with liquid nitrogen cryotherapy.

Methods:

A 1.5-mm Brymill cryoprobe was applied in a double freeze-thaw method after an incisional biopsy of a portion of the conjunctiva in patients with conjunctival lymphangiectasia. Freeze times were 1 to 2 seconds with thawing of 5 to 10 seconds between treatments. Patients were reexamined at 1 day, 2 weeks, 3 months, 6 months, and yearly following cryotherapy.

Results:

Five eyes of 4 patients (3 male and 1 female) with biopsy-proven conjunctival lymphangiectasia underwent liquid nitrogen cryotherapy. The average patient age was 53 years. Ocular examination revealed large lymphatic vessels that were translucent and without conjunctival injection. Subjective symptoms included epiphora, ocular irritation, eye redness, and occasional blurred vision. After treatment with liquid nitrogen cryotherapy, the patients’ symptoms and signs resolved within 2 weeks. Lymphangiectasia recurred twice in one patient, at 1 and 3 years postoperatively. In another patient, lymphangiectasia recurred at 6 months. The average time to recurrence in these 3 eyes was 18 months. Average length of follow-up was 24.5 months for all subjects.

Conclusion:

Liquid nitrogen cryotherapy may be an effective surgical alternative in the treatment of conjunctival lymphangiectasia. Cryotherapy may need to be repeated in some instances.

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NCBI-NLM-NIH

Conjunctival Lymphangiectasia Presenting as Pediatric Pseudopterygium.

June 2012

Pastora N, Peralta-Calvo J, Yebenes-Gregorio L, Abelairas J, Hierro-Zarzuelo A.

Source

Ophthalmology Department (N.P., J.P.C., J.A., A.H.Z.), Hospital Universitario La Paz, Madrid, Spain Pathology Department (L.Y.G), Hospital Universitario La Paz, Madrid, Spain.

Abstract

OBJECTIVES:

The aim of this study is to report a case of conjunctival lymphangiectasia simulating a pediatric pterygium.

METHODS:

A 10-year-old girl with Turner syndrome and familial history of pterygia presented because of a conjunctival growing lesion clinically consistent with pterygium in her left eye. Visual acuity (VA) was 20/20 in the right eye and 20/40 in the left eye. Cycloplegic refraction was +1.50sph -0.50cyl×93° and +9.00sph -9.00cyl×180° in the right and left eyes, respectively.

RESULTS:

Resection of the lesion with amniotic membrane implantation and conjunctival autograft was performed. The histologic examination revealed conjunctival lymphangiectasia. Ten months later, the patient did not show any signs of recurrence. Refraction in the left eye was +0.5sph -1.5cyl×70°, and spontaneous VA was 20/20 in both eyes.

CONCLUSIONS:

Pediatric pseudopterygium may be the clinical presentation of several ocular surface disorders. Thus, pathologic analysis of this lesion should be considered to determine its exact nature. Surgery lessens the refractive defect and hastens visual recovery.

Lippincott, Williams & Wilkins

Conjunctival lymphangiectasia: a report of 11 cases and review of literature.

Mar 2012

Welch J, Srinivasan S, Lyall D, Roberts F.

Source

Department of Ophthalmology, Ayr Hospital, Ayrshire and Arran National Health Service, Ayrshire, Scotland, United Kingdom.

Abstract

Conjunctival lymphangiectasia is an uncommon clinical condition in which there is dilatation of lymphatic channels in the bulbar conjunctiva. Conjunctival lymphangiectasia is a rarely appreciated ocular surface disorder that typically occurs as a secondary phenomenon in response to local lymphatic scarring or distal obstruction.

Conjunctival lymphangiectasia can either be unilateral or bilateral with focal or diffuse bulbar chemosis. We present 11 cases of biopsy-proven conjunctivallymphangiectasia. Of the 11 cases, 3 presented with bilateral diffuse bulbar chemosis, 1 had diffuse unilateral chemosis, and the remaining 7 presented with focal (<90°) bulbar chemosis.

Three of these cases had co-existing pterygium, and one case presented with focal bulbar chemosis and a conjunctival keratin horn. All underwent surgical excision of the involved conjunctiva, either with no graft (n = 6), combined with amniotic membrane transplant (n = 3), or combined with conjunctival autograft (n = 2).

Survery of Ophthalmology