Iris Cyst Research Articles

Progressive retrocorneal pigmentation in dogs: A clinical report of 34 cases.

To describe the signalment, ophthalmic examination findings, and follow-up of dogs affected with a previously unreported retrocorneal pigmentary lesion. Retrospective record evaluation spanning 2009-2019. Retrocorneal pigmentary lesions were described in 34 patients (46 eyes). German Shepherds (n=7), Jack Russel terriers (n=5), and terrier crosses (n=4) made up 16/34 (47.1%) of the cases. The mean age was 13.5years (range 1.4-14.2years), and 16/30 (53.3%) dogs were female. Most dogs were affected unilaterally (22/34 (64.7%)), the others bilaterally, and 5/34 (14.7%) were referred for it while the others were incidentally diagnosed. The lesions affected the ventral, peripheral, inner cornea and had a round/undulated leading edge. The number of corneal clock hours affected was known for 41/46 (89.1%) eyes and involved 1-3 clock hours in 32/41 (78.1%) eyes, 4-6 in 6/41 (14.6%), 7-9 in 2/41 (4.9%), and 10 in 1/41 (2.4%). The central cornea was affected in 9/46 (19.6%) eyes, and in 5/9 (55.6%), the median corneal clarity score was G2 (scale: G0-G4). The commonest additional findings included free-floating uveal cysts (11/34 dogs, 32.4%), cataracts (6/34 dogs, 17.6%), and primary glaucoma (5/34 dogs, 14.7%). Gonioscopy was available in 16/34 (47.1%) dogs and was normal except in primary glaucoma cases. Follow-up was documented in 13/34 (38.2%) dogs with a mean follow-up of 17months (range: 5-26months). Lesion progression was documented in 6/13 (46.2%) dogs. Retrocorneal pigmentation occurs as a slowly progressive lesion of older dogs that could impact vision. Histological studies of affected eyes are warranted.

A child with bilateral iris cysts: Iris Flocculi

A child with bilateral iris cysts: Iris Flocculi

Iris cyst following cataract surgery

Iris cyst following cataract surgery

Iris Stromal Cyst in a 6-Month-Old With Rapid Progression to Angle Closure

A 6-month-old female presented with an iris cyst in the left eye, first identified at age 4 months. The patient was seen by an ophthalmologist at age 6 months and referred for further management. Our examination 2 weeks later demonstrated a 6 mm diameter iris cyst originating from the anterior surface of the inferior iris, occupying the inferior two thirds of the anterior chamber and obscuring the pupil. Intraocular pressure was normal and the remainder of the anterior chamber was formed. Because of concern for the development of amblyopia, the patient was scheduled for an examination under anesthesia and iris cyst removal 2 days later. In the intervening 2 days, the patient's mother noted worsening photophobia and tearing. At the time of surgery, the intraocular pressure was 51 mm Hg in the left eye. Anterior examination demonstrated interval development of shallowing of the anterior chamber with irido-corneal and cyst-corneal touch. The iris cyst had increased to 8 mm in size and filled the entire pupillary aperture. The iris cyst was excised, and histopathology confirmed the diagnosis of an iris stromal cyst. Congenital stromal cysts of the iris can enlarge, threatening amblyopia and secondary glaucoma in children. Although angle closure is a known theoretical complication of iris stromal cysts, actual cases are rare in the literature. This case demonstrates the importance of serial examinations to monitor progression of iris stromal cysts, particularly in young children.

Successful management of a large traumatic iris cyst

Background: Iris cysts are rare lesions of the anterior segment of the eye, they can be congenital or acquired. The management of acquired post-traumatic iris cysts remains difficult. Case report: We report the case of a 24-year-old girl who presented with a progressive decrease in vision in the left eye with pain and redness for the past few months. She had a history of penetrating injury in the same eye 14 years ago. The slit lamp examination identified a corneal scar at 7’ o’clock and a large iris cyst deforming the pupillary area. Ultrasound biomicroscopy (UBM) has confirmed the benign nature of the cyst. Anterior segment optical coherence tomography (AS-OCT) has shown the contact of the external layer of the cyst with the corneal endothelium. Surgical management consisted of soft viscodissection to separate the cyst from the corneal endothelium followed by complete excision of the external layer of the cyst. Conclusion: The postoperative course was simple with good visual outcome.

Laser puncture of symptomatic primary iris pigment epithelial cyst causing hemeralopia: a rare case

Primary iris pigment epithelium cysts involve posterior surface of the iris and can occur at pupillary margin or anterior ciliary body. They may be stationary or progressive and sometimes regress spontaneously. These cyst can occasionally lead to angle-closure glaucoma, plateau iris syndrome and secondary pigment dispersion syndrome. A steadily growing cyst may disturb the vision by covering the visual axis and provoke an increase in intraocular pressure (IOP) or even inflammation if it touches the corneal endothelium. There are multiple management options in complicated situations. We report a case of a 17-year-old girl with unusual complaints of hemeralopia and dark-brown discolouration of pupils in both eyes. On examination, she had multiple pigment epithelial iris cysts at the pupillary margins, which were punctured with Nd:Yag laser, and the response was improvement in vision and hemeralopia without any pigment dispersion or IOP changes.

Iris Cysts: Clinical Features, Imaging Findings, and Treatment Results

Objectives:To report the clinical and demographic characteristics, imaging findings, treatment results, and follow-up data of patients with iris cysts.Materials and Methods:The medical records of 37 patients with iris cysts were retrospectively analyzed. Ultrasound biomicroscopy (UBM), swept-source optical coherence tomography (SS-OCT), and SS-OCT angiography (SS-OCTA) were performed to examine the iris cysts.Results:The mean age of the patients was 34.4 years, ranging from 5 to 85 years. Twenty-four patients (65%) were female and 13 (35%) were male. Mean follow-up period was 21.3 months, ranging from 4 months to 8 years. Thirty-five (94.5%) of the cysts were classified as primary and 2 (4.5%) were classified as secondary. Thirty-one (83.7%) of the primary cysts were pigment epithelial and 4 were stromal. Primary iris pigment epithelial cysts were classified as peripheral in 26 patients (72.2%), midzonal in 4 (11.1%), and dislodged in 1 (2.7%). Stromal cysts were classified as acquired in 3 patients (8.1%) and congenital in 1 patient (2.7%). Secondary iris cysts were caused by perforating eye injury. UBM could visualize both the anterior and posterior surfaces of the cysts (26 patients). Anterior segment SSOCT could visualize the anterior but not the posterior surface of the cysts (4 patients). Iris cysts did not display intrinsic vascularity on SS-OCTA (4 patients). All pigment epithelial cysts were managed by observation. Of the 4 primary stromal cysts, 3 were managed by surgical excision and 1 by observation. Two secondary cysts required surgical removal.Conclusion:Pigment epithelial cysts generally remain stable without need for treatment. However, iris stromal cysts frequently require surgical intervention. UBM and SS-OCT were valuable in the diagnosis of iris cysts. On UBM, iris cysts appear with a thin, hyperechoic wall with hypoechoic internal content. Iris cysts did not have intrinsic vascularity on anterior segment SS-OCTA.

Оптимизация лечения кист радужки

Оптимизация лечения кист радужки

Clinical observation of modified intracystic ethanol irrigation on traumatic iris cyst patients

Objective To evaluate the efficacy and safety of modified intracystic ethanol irrigation for traumatic iris cyst eyes. Methods A retrospective analysis was designed.Twelve cases of traumatic iris cyst patients were observed from August 2016 to August 2018 in Xiamen Eye Centre of Xiamen University.After anterior chamber filled with DisCoVisc, cyst fluid was drained gently via a 30-gauge needle, and ethanol was irrigated into the cyst through 3-way T-extension until the cyst wall turned white.DisCoVisc was washed in the end.Patients were followed for cornea and anterior chamber condition, best-corrected visual acuity (BCVA), intraocular pressure (IOP) and endothelial cell density (ECD). The diameters of maximal length and width in maximal cross-sectional area were calculated by ultrasound biomicroscopy (UBM) preoperatively and postoperatively.The follow-up period was 3 to 24 months.Written informed consent was obtained from each patient before surgery. Results BCVA (LogMAR) and IOP had no significant changes after surgery in one week (t=1.30, P=0.22; t=-0.91, P=0.38). BCVA was elevated in 5 cases at the last follow-up, but declined in 3 cases, kept stable in 4 cases.Mean intensity of ECD before and 3 months after operation was (2 270.79±458.43)/mm2 and (2 111.52±483.46)/mm2, respectively, the mean loss of ECD was 159.27 cells/mm2, and there was a significant change between the two time points (t=3.76, P=0.00). Mean postoperative maximal length diameter before and 3 months after operation was (5.87±0.95)mm and (1.46±0.83)mm, mean postoperative maximal width diameter was (3.10±0.55)mm and (0.89±0.47)mm, respectively, the mean postoperative maximal length diameter was reduced by 5.33 mm, and the mean postoperative maximal width diameter was reduced by 2.22 mm, with significant changes between the two time points (t=18.55, P=0.00; t=11.75, P=0.00). All cysts were resolved and without recurrence at the last follow-up.No significant complications, such as cornea endothelial decompensation, endophthalmitis, sympathetic ophthalmia and retinal detachment were seen during the follow-up period. Conclusions Modified intracystic ethanol irrigation is a safe and effective procedure to treat traumatic iris cysts, which is more simple with less injury and low rate of complications. Key words: Iris cysts; Modified intracystic ethanol irrigation; Ocular trauma

Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors.

Purpose To report the surgical treatment and follow-up of tumors of the anterior uvea and epithelial cysts of the anterior chamber in 4 patients submitted to block excision and tectonic corneal graft between 2008 and 2012. Methods This is a retrospective, nonrandomized case series. Two patients were affected by anterior uveal malignant melanoma, and 2 patients were referred to us for large epithelial iris cysts with anterior chamber angle involvement and partial corneal failure. A simultaneous block removal of the lesion and adjacent iris, cornea (when necessary), ciliary body, and sclera was performed; the resulting defect was covered by a tectonic whole thickness corneal graft. Follow-up ranged from 2 to 7 years (mean time: 5 ± 1.6 MD). Results Local control of malignant melanoma was observed during the follow-up, but cataract surgery was planned in both patients and pars plana vitrectomy for vitreous hemorrhage occurred in one case. No recurrence of cysts was detected. After iris cysts excision, a planned second-time surgery was necessary in one patient: optical penetrating keratoplasty, centered on the visual axis, implantation of one refractive IOL (intraocular lens) in the bag, and one cosmetic IOL in the sulcus, to restore the iris diaphragm. Conclusions Block excision followed by the tectonic corneal graft seems to be the treatment of choice for selected cases of epithelial cysts of the anterior chamber and anterior uvea melanomas with epibulbar extension. Further surgery, as a second step, could be required to improve functional results of this challenging technique.

Iris metastases as an unusual ocular manifestation in renal cell carcinoma

The most common intraocular malignancy in adults is metastases from a systemic malignancy. The choroid is the most common site followed by iris and ciliary body; other sites being orbit, eyelids, lacrimal glands, extraocular muscles, and bulbar conjunctiva. However, iris metastases from renal cell carcinoma (RCC) have been reported sparsely in the literature. The present case report describes the unique morphology of iris metastases thought initially to be a benign iris cyst which later proved to be secondary metastases from RCC. This article also describes briefly the review of the relevant literature and the management protocol in such patients.

Implantable collamer lens surgery in patients with primary iris and/or ciliary body cysts

BackgroundThe prevalence of primary iris and/or ciliary body cysts is common in myopia, though asymptomatic in nearly all cases. It’s a very valuable thing to study the clinical safety and reliability of implantable collamer lens (ICL) surgery in patients with primary iris and/or ciliary body cysts.MethodsA total of 108 patients (201 eyes) were included in this retrospective study. All eyes had been implanted with V4c implantable collamer lens (ICLV4c). According to the eyes with or without primary iris and/or ciliary body cysts, all eyes were divided into two groups. We observed preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity)(CDVA), intra-ocular pressure(IOP), anterior chamber volume(ACV), anterior chamber depth(ACD), trabecular-iris angle (TIA), angle opening distance at 500 μm (AOD500),vertical central distance between the corneal endothelium and the front surface of ICL(CE-ICL), and the central vault. The follow-up periods covered 12 months.ResultsAmong all the 201 eyes, primary iris and/or ciliary body cysts were detected in 54 eyes (26.87%),but the prevalence was account to 36.11%(18males,21females).There were 30 eyes (55.56%) with unilateral single cyst, 12 eyes (22.22%) with unilateral double cysts, 12 eyes (22.22%) eyes with unilateral multiple and/or multi-quadrants cysts, the mean size of cysts was (0.714 ± 0.149)mm(range from 0.510 to 1.075 mm).30.4% of the cysts were located at iridociliary sulcus, 65.5% in pars plicata, and 4.1% in midzonal iris, which showed a characteristic distribution pattern, with cysts found predominantly in the inferior and temporal quadrants.The postoperative size and the number of cysts showed nearly no changes. The postoperative ACV, AOD500 and TIA showed a statistical reduction in both two groups (P < 0.05), but with no statistical significant between the two groups (P > 0.05), the parameters of postoperative IOP,CE-ICL and central vault also showed the same results as which. We did not observe serious complication and IOP elevating in the whole follow-up periods.ConclusionPrimary iris and/or ciliary body cysts are not absolutely contraindication for ICL surgery. For some single cyst smaller than 1.075 mm or single quadrant cysts located at ciliary body are rare to lead some serious complications. But, for some multiple cysts, especially multi-quadrants cysts located at iridociliary sulcus, we still should remain cautions.

Surgical management of acquired implantation iris cysts: indications, surgical challenges and outcomes

PurposeTo describe the clinical spectrum, clinicopathological correlation and outcomes of different surgical strategies in the management of acquired implantation iris cysts.MethodsFrom 1 January 1989 to 31 December 2015, 27 patients...

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

Implanting a posterior chamber phakic intraocular lens in highly myopic eyes with peripheral primary iris and ciliary body cysts.

To investigate the safety and efficacy of implanting a posterior chamber implantable collamer lens with a central hole in cases of high myopia with peripheral primary iris or ciliary body cysts. A total of 37 eyes of 19 patients with primary iris or ciliary body cysts detected by ultrasonic biological microscope were included, with spherical powers of -10.26 ± 3.28 D and cylinder powers of -1.71 ± 1.18 D. Each patient received ultrasonic biological microscope and a routine examination before implantation of the implantable collamer lens. A routine postoperative follow-up was performed to observe changes in the iris or ciliary body cyst, ranging from 3 to 18 months. There were no complications. At the last follow-up, 56.8% (21/37) of eyes achieved the same corrected distance visual acuity as their preoperative measurements, 43.2% of eyes were enhanced by ≥1 line, and no patients' corrected distance visual acuity declined. The efficacy index and safety index were 0.95 and 1.11, respectively. After 18 months, 66.7% of the spherical equivalents were between ±0.5 D with 100% between ±1.0 D. The postoperative mean spherical equivalents at 1, 3, 6, 12, and 18 months were -0.45 ± 0.31 D, -0.39 ± 0.29 D, -0.36 ± 0.30 D, -0.39 ± 0.38 D, and -0.48 ± 0.23 D (p = 0.789). The vaults were 516 ± 140, 548 ± 124, 498 ± 133, 582 ± 161, and 557 ± 110 μm (p = 0.355). There were no changes in size (p > 0.05), number, or position of the iris or ciliary body cysts. Implantable collamer lens implantation is safe and effective for highly myopic patients with peripheral primary iris and ciliary body cysts. The cysts did not change after operation in this study.

A Case of Spontaneous Recovery of an Iris Cyst in a Patient with Peritoneal Tuberculosis

A Case of Spontaneous Recovery of an Iris Cyst in a Patient with Peritoneal Tuberculosis

Ultrasound biomicroscopy as a guideline for management of secondary iris cysts: a case series study

Purpose The aim of this study was to evaluate the role of ultrasound biomicroscopy (UBM) in diagnosis, decision of intervention, and follow-up monitoring of secondary iris cysts. Patients and methods This case series study included 17 patients diagnosed clinically of having secondary iris cysts. History and full ophthalmological examination included visual acuity testing and slit lamp examination. UBM and B-scan ultrasound were performed for all cases. The study cases were divided into two groups according to the management plan (surgical management group and follow-up group). The follow-up period was 1 year. Results The study included 17 cases with unilateral secondary iris cysts. They were five females and 12 males, with age range from 3.0 to 44 years and a mean of 9.01±10.76 years. The clinical presentations such as blurring of vision, uveitis, red eye, ocular pain, or disfiguring intraocular swelling were insignificantly related to the different management groups (P>0.05). Angle closure and corneal touch (detected by UBM) were significantly present in the surgically managed cases, with P values of 0.003 and 0.009, respectively. The cyst size dimensions and its relation to the visual axis were detected with an insignificant difference between both groups. Conclusion UBM had a great value in the diagnosis of secondary iris cysts. Certain UBM findings were very important in deciding the different management plans and follow-up monitoring.

Recurrence of a small primary iris stromal cyst following treatment with Nd:YAG laser photodisruption in an adult

Introduction. Primary acquired iris stromal cyst is rare in adults. In this group, they are generally stable lesions which require no treatment. Case outline. We describe a rare case of a small primary iris cyst in a 39-year-old patient, associated with unusual signs of irritation. Ultrasound biomicroscopy demonstrated iris stromal cyst measuring 3 ? 2 mm. A neodymium-doped yttrium aluminium garnet (Nd:YAG) laser cystotomy was engaged as the least invasive treatment approach. However, the cyst recurred soon after repeated laser treatment and sector iridectomy with excision of the cyst was performed. Five years after surgery there was no evidence of recurrence. Conclusion. Although more benign clinical course of primary stromal iris cyst is generally assumed in adults as compared to children, complete cyst removal seems to be mandatory for preventing cyst recurrence regardless of the cyst size or patient age. To the authors? knowledge this is the first documented report of Nd:YAG laser photodisruption of acquired primary iris stromal cyst in an adult.

Symptomatic primary iris cysts treated with frequency-doubled Nd:YAG laser photocoagulation

Relatamos o caso de uma mulher de 31 anos com queixa de visão turva no olho esquerdo. Exame em lâmpada de fenda e tomografia de coerência óptica mostraram quatro lesões císticas nas margens da pupila esquerda. O laser do tipo Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) de dupla-frequência foi o tratamento de escolha para romper a parede (cistotomia), drenar o conteúdo do cisto e encolher os remanescentes do epitélio de pigmentar utilizando os menores parâmetros efetivos. Após o tratamento do olho comprometido, sua acuidade [...]

Large Non-traumatic Iris Cyst

Iris cysts are uncommon ocular pathologies and their surgical excision is often difficult owing to their location and fragile nature. Herein, we report a patient who complained of progressive, painless blurring of vision in the left eye for six months. On examination, a large smooth non-transilluminant iris mass was seen extending from 11 o’clock to 5 o’clock region and touching the corneal endothelium. Surgical excision was performed and the patient’s vision improved from HM to 6/48.