Evaluation of Subconjunctival Remnant Particles after High-frequency Radio-wave Electrosurgery for Conjunctivochalasis

PURPOSE: To investigate the clinical manifestations and properties of remnant particles in the subconjunctival space after high-frequency radio-wave electrosurgery for conjunctivochalasis. METHODS: We performed a retrospective, observational case series with in vitro experimental imaging in nine eyes from eight patients who presented with small dark-gray lesions during follow-up after high-frequency radio-wave electrosurgery for conjunctivochalasis. General examination including slit-lamp examination and visual acuity testing was performed preoperatively and postoperatively. During follow-up, we evaluated remnant particles and any other complications including granuloma or conjunctival injection with slit-lamp photography and anterior optical coherence tomography. Coagulation tips were investigated with scanning electron microscope and energy dispersive X-ray spectroscopy to analyze the insulating electrode and assess changes to tips after repeated use. RESULTS: None of the patients included in this study experienced any change in visual acuity or major complications postoperatively. Small dark-gray lesions (0.3 to 0.5 mm in size) were observed in the inferior bulbar sub-conjunctival space in the location where high-frequency radio-wave electrosurgery had been performed. Cirrus high-definition optical coherence tomography images revealed focal hyper-reflection with a posterior shadow, suggesting foreign particles. Scanning electron microscopy and energy dispersive X-ray spectroscopy imaging analysis revealed peaks of carbon and fluorine complexes, consistent with the polytetrafluoroethylene coating on the electrode. CONCLUSIONS: There were no instances of inflammatory reaction, particle migration, or major complications due to particles. Physicians should be aware of the possibility of remnant polytetrafluoroethylene particles in subconjunctival tissue when using insulated coagulation tips subjected to repeat sterilization.

Removal of Eyelid Epidermal Cyst Using High-Frequency Radio-Wave Electrosurgery

PURPOSE: To introduce an effective new surgical approach with high-frequency radio-wave electrosurgery to remove eyelid epidermal cysts. METHODS: Thirteen patients (13 eyes) with eyelid epidermal cysts were enrolled in the present study. All patients underwent high-frequency radio-wave electrosurgery (Ellman surgitron(R)) to remove the epidermal cyst. The results were analyzed retrospectively, after a follow-up of more than 6 months. RESULTS: At 6 months postoperatively, all eyes showed no recurrence of epidermal cyst. Additionally, no complications were reported by any patient. CONCLUSIONS: High-frequency radio-wave electrosurgery is an effective procedure to remove eyelid epidermal cyst without recurrence.