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.

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,

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.