Removal of lymphangiectasis using high-frequency radio wave electrosurgery

PURPOSE:: To describe a novel technique using high-frequency radio wave electrosurgery (Ellman Surgitron Dual Frequency RF; Ellman International, Inc) for the management of lymphangiectasis. METHODS:: Ablations were performed at the lowest power setting of 1 (of 100) in the cutting mode, producing the least amount of lateral heat. To prevent conjunctival hemorrhage, ablation was initiated immediately before introducing the tip of a needle electrode into the subconjunctival tissue under the target area. After the tip of the electrode reached the target area, ablation was maintained for 1 to 2 seconds on the surrounding area and for a longer time on the dilated lymphatic vessels, until the target conjunctiva blanched. These ablations were performed cautiously with the fine electrode to avoid thermal injury to the adjacent scleral tissue. RESULTS:: Persistent lymphangiectasis accompanied by accumulated fluid was successively treated with high-frequency radio wave electrosurgery. Surgical time was less than 5 minutes. There were no intraoperative complications. Fourier domain optical coherence tomography revealed resolution of the accumulated fluid and a decrease of dilated lymphatic vessels. Postoperatively, no notable complications, such as charring, scarring of Tenon capsule, or symblepharon resulting from excessive cauterization, were observed. CONCLUSION:: High-frequency radio wave electrosurgery may be a safe, quick, and effective modality for the treatment of symptomatic lymphangiectasis patients.