A Case of Secondary Iris Cyst AfterPupilloplasty

Purpose: To investigate the pathogenesis of a secondary iris cyst with an immunohistochemical method. Methods: Single observational case report. A pathologic specimen was obtained from a 5-year-old girl who was found to have a secondary iris cyst. She had a history of previous penetrating ocular trauma and subsequent cataract surgery and pupilloplasty. Immunohistochemical staining with cytokeratin (CK) 19 and CK3 was used. Results: After immunohistochemical staining, the inner wall showed positive staining for CK19, which is specific for limbal, peripheral cornea and conjunctival epithelium, and negative staining for CK3, which is specific for corneal epithelium. Conclusions: With the aid of immunohistochemical analysis, a conjunctival epithelial origin was indicated, and pupilloplasty was identified as the causal event of the iris cyst while the possibility of primary iris cyst was ruled out.

Primary Pupillary Margin Cyst of the Iris Pigment Epithelium

Purpose: Description of a patient with a solitary cyst of the pupillary margin iris pigment epithelium (IPE). Methods: A 63-year-old man referred a suspected iris-ciliary body melanoma in his left eye. Based on both clinical examination and ultrasound biomicroscopy, melanoma was considered unlikely. Surgery was under-taken to correct recurrent deterioration of vision due to movement of the lesion across the visual axis. Results: The lesion was excised completely. Ultrasound biomicroscopy and histopathological examination ruled out melanoma and allowed a final diagnosis of primary pupillary margin cyst of the IPE, characterized of pig-mented epithelium, with no connective tissue or vessels. No recurrences or fresh lesions appeared during a one-year follow-up. Conclusions: Primary epithelial iris cysts are usually benign. Treatment is required only in symptomatic patients and those with an uncertain diagnosis. Ultrasound biomicroscopy is indispensable to confirm the clinical diagnosis, follow the clinical course and intervene if surgery is required.

Acquired iris inclusion cysts

Dear Sir/Madam,The development of epithelial implantation cysts of the iris is rare and they pose a major therapeutic challenge due to the poor overall surgical outcome and high risk of recurrence.Several conservative and invasive treatment strategies such as needle aspiration,viscodissection,endolaser photocoagulation,endodiathermy,cryotherapy,

A giant traumatic iris cyst

A 52 year-old construction worker presented with progressive painful blurring of vision in the left eye associated with redness for past 1 month.There was a history of penetrating injury in the same eye 10 years ago and he underwent primary wound toilet and suturing,lens removal with intraocular lens implantation.Slit lamp examination revealed a corneal scar at 9’oclock,a large transilluminant iris cyst superotemporally and adherent to corneal endothelium.It was extended from angle of the pupil and obstructing the visual axis.The patient underwent excision of an iris cyst through superior limbal incision.Viscodissection was done to separate the cyst from the corneal endothelium and underlying iris stroma.Trypan blue ophthalmic solution was injected into the cyst to stain the cyst capsule.Post operatively 7 days,vision improved to 6/7.5 without complication.There was no recurrence up to 1 year postoperation.Histopathological finding revealed a benign cyst mass lined by simple cuboidal to nonkeratinized stratified squamous epithelium.We had achieved a good surgical outcome with no complication to date for our case study.We advocate this modified surgical method to completely remove iris cyst.

Effect of primary iris and ciliary body cyst on anterior chamber angle in patients with shallow anterior chamber

Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-quadrants cysts manifested significant narrowing of the entire anterior chamber angle as compared with the eyes without cysts,based on the data analysis in comparison of TIA,AOD500,and gonioscopic grading evaluation.The unilateral single or double cysts in the eyes had no significant effect on narrowing of anterior chamber angle as compared with eyes without cysts.The iris and/or ciliary body cysts did not seem to affect the axial length,ACD,lens thickness,RLP,LAF.Conclusions:The prevalence of primary iris and ciliary body cyst was 34.4% in the subjects with shallow anterior chamber.The cysts larger than 0.8 mm,locating at iridociliary sulcus,or multiple and extensive cysts were inclined to cause the angle narrowing or closure.

Clinical observations of iridociliary cysts and their changes after implantable collamer lens implantation in myopic patients

AIM:To observe the characteristics of iridociliary cysts in myopic patients and evaluate the influences on the position and safety of implantable collamer lens(ICL)after surgery.METHODS:Totally 270 eyes of 135 patients who underwent ICL surgery for the corrections of myopia were included in this study.Preoperative and postoperative morphology of iridociliary cysts were observed in ultrasonic biomicroscopy(UBM)image.RESULTS:A total of 138 iridociliary cysts were found in 88 eyes of 50 patients among 270 eyes of 135 patients before surgery(37%).Twenty-five patients had cysts in one eye(50%)and 25 had cysts in both eyes(50%).The prevalence of iridociliary cysts was negatively correlated with age,but no gender difference(P>0.05).The incidence of iridociliary cysts was much less in eyes with myopia greater than-9.00 D(P<0.05).The diameter of the largest cyst was 1.96 mm and the smallest cyst was 0.24 mm,with a majority within the range of 0.5 to 1.0 mm.Most of the cysts were located in the inferior temporal quadrant.One year after ICL implantation,51 iridociliary cysts(37%)remained unchanged,47 cysts(34%)decreased in size,and 40 cysts(29%)disappeared.Most of cysts that changed after surgery were smaller than 1.0 mm(P<0.05)and located in the nasal and temporal sides around the haptics of implantable lens.All the ICL were in their original position.CONCLUSION:Iridociliary cysts are commonly seen in myopic eyes.The cysts have no impact on the safety of ICL surgery.Some cysts may decrease in size or disappear after ICL implantation.

Orbital Epithelial Implantation Cyst Presenting 40 Years after Orbital Trauma

Here we present an unusual case of an epithelial implantation cyst within the orbit which presented 40 years after initial injury from an airgun pellet. A retrospective review of the case was performed. This case highlights the importance of taking a thorough history when assessing adnexal lesions of undetermined origin.

Malignant transformation of aneurysmal bone cysts： a case report

An aneurysmal bone cyst is a non-neoplastic, .destructive and expansile lesion consisting of a＂blood-filled sponge＂ that is defined to represent a benign reactive vascularity. Szendroi et al suggested that the aneurysmal bone cyst corresponds to a haemodynamic disturbance that is primary or secondary venous malformation of the bones. The association with trauma including fracture has also been noted and 25%-71% of such patients have a history of trauma. Conventionally, malignant transformation of aneurysmal bone cysts is perceived as a rare occurrence except those induced by irradiation. Both malignant fibrous histiocytoma and osteosarcoma have been reported in the malignant transformation cases.

上颌侧切牙重度畸形舌侧沟多学科联合治疗1例并文献复习

畸形舌侧沟是上颌切牙尤其是侧切牙常见的发育畸形,常引起牙周组织的破坏。本文报告1例畸形舌侧沟引发的牙周-牙髓联合病变误诊为单纯的根尖周囊肿的病例,经完善根管治疗及根尖周囊肿刮除术后病程迁延不愈,造成患牙区域颊、颚侧骨板缺如,后通过拔除患牙同期行位点保存术,后期配合种植修复,得到临床治愈。畸形舌侧沟隐匿性强、临床表现往往不典型,如有上颌侧切牙脓包反复发作或深牙周袋持续存在,应完善影像学检查,必要时行牙周翻瓣术探查牙根面形态。

人工晶状体预先巩膜悬吊在严重晶状体半脱位中的应用

目的:探讨人工晶状体(IOL)预先巩膜悬吊在严重晶状体半脱位中的应用效果。方法:选取2018年12月至2022年7月四川省人民医院收治的>180°的严重晶状体半脱位患者8例(8眼)。术中避开脱位的晶状体,预先将IOL悬吊于玻璃体腔,再将晶状体托起置于IOL上方,必要时辅助以虹膜拉钩,稳定晶状体,确保超声乳化手术安全完成。结果:严重的晶状体半脱位患者8例,其中晶状体核N1-N3硬度的患者各1例,单独使用IOL预先巩膜悬吊于术中稳定脱位的晶状体,3例超声乳化手术均顺利完成;达N4患者3例、N5患者2例,其中4例在虹膜拉钩的辅助下安全完成超声乳化;有1例N5的患者,由于悬韧带损伤超过270°,在将晶状体托起放置于IOL之上时,坠入玻璃体腔,给予玻璃体腔超声粉碎处理。8例患者术后IOL均居中,视力有不同程度的提高,眼压正常,未见严重并发症。结论:在严重晶状体半脱位的超声乳化手术中,对于N2~N3的软核,IOL预先巩膜悬吊可以良好地稳定晶状体,确保超声乳化手术的顺利进行;对于N4~N5的硬核,IOL预先巩膜悬吊可以作为一种辅助方法,联合虹膜拉钩共同稳定晶状体,确保超声乳化手术的安全进行。

上颌前牙区囊肿髂骨植骨术后种植修复1例5年回顾

本文报告1例上颌前牙区颌骨囊肿病例,行颌骨囊肿刮除术后,前牙区遗留大量骨质缺损,应用髂骨自体骨块进行骨增量,术后8个月进行延期种植修复,最终修复效果理想。

介入治疗卵巢子宫内膜异位囊肿的临床资料探讨

目的探讨与分析介入治疗卵巢子宫内膜异位囊肿的价值。方法采用随机、平行、对照设计方法进行研究,随机选取2019年3月—2023年10月贵州中医药大学第二附属医院收治的76例卵巢子宫内膜异位囊肿患者为研究对象。根据随机数表法把76例患者分为介入组38例与对照组38例。手术组给予腹腔镜手术治疗,介入组给予介入治疗,记录介入组与手术组的治疗疗效及并发症。结果治疗3个月后介入组的总有效率为97.37%,与手术组的100.00%相比,差异无统计学意义(P>0.05)。介入组与手术组治疗3个月后的血清糖类抗原125(carbohydrate antigenm125,CA125)水平与治疗前对比显著降低,差异有统计学意义(P<0.05);介入组治疗前、治疗3个月后的血清CA125水平与手术组相比,差异无统计学意义(P>0.05)。术后介入组发热患者2例(5.26%),手术组发热患者8例(21.05%),差异有统计学意义(χ^(2)=4.145,P<0.05)。结论介入治疗卵巢子宫内膜异位囊肿的有效性好,为临床诊疗提供了一种微创精准、操作简便、成本低、并发症少、恢复快的诊疗方式。

颌骨囊肿刮除联合CGF治疗后延期种植1例报道

目的报道颌骨囊肿刮除联合浓缩生长因子(CGF)治疗后延期种植1例,探讨颌骨囊肿术后骨缺损处理方式。方法1例患者于外院拔牙后1个月,因术区不适来我院检查行锥形束计算机断层扫描(CBCT)检查,发现患者为左下颌骨囊肿,行囊肿刮除术联合CGF填塞治疗,1年后延期种植。结果刮除术后1年,术区成骨,延期种植术后11个月随访,种植体周围无暗影,骨密度正常。结论CGF具有促进骨组织恢复的作用。

上颌窦底提升植骨术中囊肿的处理策略

上颌窦底提升植骨术作为一种可靠的治疗方法,通过剥离提升上颌窦底壁的黏膜,形成容纳血液和骨移植材料的空间,从而增加上颌后部骨高度以满足种植体植入的需求。该技术包括经外侧壁开窗入路提升和经牙槽嵴顶入路提升两种术式,受诸如上颌窦底黏膜厚度、窦底解剖形态、上颌窦病变等的影响,其中上颌窦囊肿的存在会增加治疗的难度和手术风险。目前对于上颌窦底提升术中是否对囊肿进行处理以及如何进行处理仍存在争议,本文将针对上颌窦底提升植骨种植术中遇到的上颌窦囊肿问题的不同处理策略做一概述。

前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性

目的探讨前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性。方法选择河北省眼科医院白内障科2013年1月至2020年12月行晶状体摘出一期或二期植入前房型虹膜夹人工晶状体的患者53例62眼作为研究对象,62眼患者均为无足够囊膜支撑的无晶状体眼。术后随访3~9(5.68±1.29)年,收集患者手术前和末次随访裸眼视力(UCVA)、等效球镜度、眼压、前房深度、人工晶状体眼内固定位置及稳定性、角膜内皮细胞密度(ECD)、术后并发症等指标和临床信息。评价前房型虹膜夹人工晶状体植入术治疗无足够囊膜支撑的无晶状体眼的疗效和安全性。结果术前62眼UCVA(logMAR)为1.55±0.56,术后为0.23±0.15,术后UCVA较术前显著提高(t=18.64,P=0.00)。术后和末次随访UCVA(logMAR)(0.22±0.14)比较,差异无统计学意义(t=1.43,P=0.16),患者术后视力保持稳定。术后末次随访1眼等效球镜度为-1.25 D(为根据另一眼预留),等效球镜度-1.00~<-0.50 D者10眼,-0.50~+0.50 D者51眼。62眼术前眼压为(14.20±2.20)mmHg(1 kPa=7.5 mmHg),其中12眼于术后第1天开始出现眼压升高,达28.0~40.3 mmHg(主要原因是黏弹剂眼内残留并继发青光眼,经过降眼压处理后,眼压于3 d内恢复至正常范围);末次随访眼压为(13.92±2.10)mm⁃Hg,术前与末次随访眼压差异无统计学意义(t=0.25,P=0.90)。术前62眼ECD为(2826.3±489.8)个·mm^(-2),末次随访为(2474.3±397.6)个·mm^(-2),术前和末次随访ECD差异有统计学意义(t=6.82,P=0.00)。一期脱位晶状体或人工晶状体摘出联合前房型虹膜夹人工晶状体植入术后41眼ECD平均下降11.25%,二期前房型虹膜夹人工晶状体植入术后21眼ECD平均下降5.23%。术后共5眼ECD减少超过15%,均为开展手术早期的前5例患者。末次随访62眼前房深度为(2.40±0.32)mm,裂隙灯眼前节照相系统动态检查及眼前节OCT静态检查人工晶状体周边部和角膜内皮之间均无接触。术后ECD减少超过15%的5眼中,3眼发生人工晶状体一侧襻脱位;2眼因虹膜夹夹取的虹膜组织较少进行了再固定手术。再固定手术后人工晶状体在眼内位置稳定,再固定后的患者未再发生脱位。结论前房型虹膜夹人工晶状体植入术可有效改善无足够囊膜支撑的无晶状体眼患者中远期术后视功能,稳定眼压;术中虹膜夹人工晶状体襻必须充分夹取虹膜组织,才能维持其远期稳定性;术后需长期关注人工晶状体位置及角膜内皮变化,防止角膜内皮细胞减少。

虹膜缺损眼人工晶状体植入术

目的 探讨治疗先天性和外伤性虹膜缺损或同时伴有白内障的有效方法。方法 对眼外伤致虹膜缺损和先天性虹膜缺损患者 2 1例 2 3眼 ,采用白内障摘出术联合虹膜型人工晶状体囊袋内植入术或人工虹膜合并人工晶状体囊袋内植入术。结果 术后随访 3～ 18个月 ,平均 9.6个月 ,术后视力较术前视力提高 ,术后最佳矫正视力 >0 .5者 12眼( 5 2 .17% ) ,0 .1～ 0 .5者 9眼 ( 39.13% )。 2 2眼畏光消失 ,1眼畏光减轻。未发生严重并发症。结论 虹膜型人工晶状体囊袋内植入术或人工虹膜合并人工晶状体囊袋内植入术治疗虹膜全部缺失或虹膜部分缺损白内障或无晶状体眼安全。

虹膜囊肿的临床病理观察

目的:探讨虹膜囊肿的致病原因,临床和组织病理学特点,治疗方式和影响预后的因素。方法:回顾性分析1986/2003我科收治的27例27眼虹膜囊肿患者的临床资料包括眼部病史、术前术后眼部检查,治疗方式,组织病理学检查,预后情况。结果:27例患者年龄从3～60岁,男16例,女11例;20例继发于眼外伤后,1例继发于白内障手术,1例继发于葡萄膜黑色素瘤,其余5例为原发性;其中23例给予囊肿切除联合部分虹膜切除术,1例行玻璃体切割术,3例予以眼内激光光凝术。术后组织病理学检查显示22例继发性虹膜囊肿中有21例为上皮植入性囊肿,1例(继发于葡萄膜黑色素瘤)为虹膜色素上皮囊肿,5例原发性虹膜囊肿中4例为非色素上皮囊肿,1例为色素上皮囊肿。术后随访2a,2例因囊肿复发再次手术,1例因眼压升高再次手术。结论:虹膜囊肿根据病因可分为原发性和继发性虹膜囊肿,从组织病理学上分为上皮植入性囊肿,非色素上皮囊肿和色素上皮囊肿。组织病理学特点与病因相关。有效的治疗方式为囊肿切除联合部分虹膜切除,预后与眼部组织受损情况和治疗方式有关。

上皮植入性虹膜囊肿30例临床观察与治疗

目的探讨上皮植入性虹膜囊肿的发病原因、临床特点及治疗效果。方法回顾性分析我院1992年1月～1997年6月间收治的上皮植入性虹膜囊肿30例。结果继发于角膜穿通伤26例．爆炸伤2例，白内障摘除术后1例，穿通性角膜移植术后1例。其中2例术前行超声生物显微镜检查。7例行Nd：YAG激光治疗，不久均复发，改手术治疗。30例采用显微手术切除植入性虹膜囊肿，3例复发，术后随访时间6个月～5年。结论显微手术切除植入性虹膜囊肿，组织损伤小，复发率低。超声生物显微镜检查对本病的诊断及鉴别很有价值。

虹膜固定型人工晶状体二期植入治疗无晶状体眼的疗效

目的评价二期植入虹膜固定型人工晶状体治疗各种原因导致的无晶状体眼的疗效。方法选取无晶状体眼患者15例(16眼),均植入虹膜固定型人工晶状体,术后观察患者视力、眼压、角膜内皮细胞计数及并发症情况。结果 15例均一次性成功植入虹膜固定型人工晶状体,显微镜观察人工晶状体位于瞳孔中央。术后裸眼视力0.02-0.80,平均0.35,与术前裸眼视力(手动-0.12)比较差异有统计学意义(P<0.001),与术前矫正视力比较差异无统计学意义(P>0.05)。术后6个月角膜内皮细胞平均丢失率为9.87%。仅1例术后发生瞳孔区玻璃体阻滞。手术前后眼压差异无统计学意义(P>0.05)。结论实施虹膜固定型人工晶状体二期植入术治疗无晶状体眼,能够安全、有效地提高患者的术后视力,但人工晶状体对角膜内皮、虹膜等组织的长期影响还需进一步观察。

植入性虹膜囊肿11例临床分析及手术治疗

目的分析植入性虹膜囊肿的临床特点及其手术治疗的方法。方法收集11例植入性虹膜囊肿患者临床资料,分析其临床特点。术前超声生物显微镜明确囊肿病变范围及毗邻关系,施行虹膜囊肿切除或联合手术,切除组织行HE染色。结果囊肿切除联合节段虹膜切除术5例;囊肿切除联合穿透性角膜移植手术4例,其中1例联合前部玻璃体切割术;囊肿切除联合异体巩膜修补1例;内窥镜下经睫状体切除囊肿1例。术后平均视力0.3,眼压14-22mmHg（1kPa=7.5mmHg）,观察期内所有病例均无复发。结论彻底的联合手术摘除是植入性虹膜囊肿首选的治疗方法,超声生物显微镜指导下囊肿彻底切除是防止复发的关键。