title: Case of the weeping wound: formation of a lacrimal pseudocyst following lateral canthal surgery.
abstract: An 87-year-old woman presented with a subcutaneous fluid collection overlying the right lateral orbital rim 2 days after undergoing a lateral tarsal strip. Drainage and excision of fibrinous granulation tissue occurred twice within the first postoperative month, with the formation of a lacrimal pseudocyst. The pseudocyst repeatedly enlarged following drainage, necessitating 4 needle aspirations. A third attempt at excision, coupled with cautery to the wound base, and loose wound closure succeeded in breaking the cycle of pseudocyst recurrence. However, the wound continued to drain, so aggressive cautery and botulinum toxin were used to obliterate the area of presumed lacrimal gland laceration and slow tear production. The possibility of damage to the lacrimal system should be entertained in the scenario of a postoperative weeping wound. Formation of a lacrimal pseudocyst should be considered when a cystic lesion appears following surgical intervention in the lateral canthal region.
authors: *Carver College of Medicine, University of Iowa, Iowa City, Iowa; †Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida; and ‡Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, U.S.A.
authors: Thomas J
authors: TJ
authors: Clark
authors: Sander R
authors: SR
authors: Dubovy
authors: Erin M
authors: EM
authors: Shriver
mesh_terms: D000369:Aged, 80 and over; D002425:Cautery; D003228:Conjunctiva / Q000601:surgery; D003560:Cysts / Q000209:etiology* / Q000601:surgery; D004322:Drainage; D005122:Exudates and Transudates; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009801:Oculomotor Muscles / Q000601:surgery; D011183:Postoperative Complications; D012008:Recurrence; D014945:Wound Healing