Secondary Iris Cysts Research Articles

The Diagnosis and Treatment of a Post-traumatic Iris Cyst Referred as an Iris Tumor

Purpose: We report the diagnosis and treatment of a secondary iris cyst in a patient referred for an iris tumor.Case summary: A 29-year-old man diagnosed with an anterior chamber mass of the left eye was referred to our center for further evaluation and management. Twenty years previously, he suffered a penetrating ocular injury of his left eye and underwent primary closure. He had no underlying systemic disease. At his initial visit, the best corrected visual acuity of his left eye was 0.5. A whitish-gray mass was observed within the anterior chamber from 1 o'clock to 5 o'clock, obscuring the pupil. Anterior segment optical coherence tomography revealed a cystic mass touching the retrocorneal surface. No other lesions were seen on orbital imaging or ocular ultrasonography. Ultimately, it was diagnosed as an iris cyst that occurred secondary to ocular trauma. After needle aspiration and intracystic injection of 99% ethanol, the cyst collapsed fully. However, a cataract developed within a few months, and phacoemulsification and intraocular lens implantation were performed. Seven months after cyst aspiration, the uncorrected visual acuity of the left eye had recovered to 0.5. The cyst still adhered to the corneal endothelium, remaining in its collapsed state. The current corneal endothelial cell density is 871 cells/mm<sup>2</sup>.Conclusions: A secondary iris cyst was diagnosed in a patient with a history of penetrating eye trauma and surgery. It was treated successfully with needle aspiration and intracystic alcohol injection.

Managing Iris Cysts with Surgical Excision: A Case Series

Introduction : Iris cysts are uncommon iris tumors. Primary iris cysts are congenital and usually not detected until late into the first or second decade of life. Secondary iris cysts have history of trauma or intraocular surgery. Small and asymptomatic iris cysts should be monitored, whereas larger cysts require treatment as they cause complications.
 Case Illustration : Case 1 a 17-year-old teenager had blurred vision without prior intraocular trauma or surgery. Anterior segment examination of the left eye revealed an oval, light brown, and semi-translucent cyst. Case 2 a 15-year-old girl had blurred vision and enlarging white spot in right eye with history of penetrating ocular trauma. Patient had undergone immediate penetrating repair followed by combination of pupilloplasty and cataract surgery. Anterior segment examination of the right eye showed corneal scar and cystic lesion. Both cysts extended to corneal endothelium and were managed surgically.
 Discussion : Larger cysts, especially with complications, require cyst aspiration, laser therapy, injections of antiproliferative agents, or surgery. We decided to surgically aspirate and excised iris walls to remove both iris cysts which were vital to achieve good result. Post-operative periods were uneventful with no significant inflammatory reactions associated with the procedure.
 Conclusion : Different modalities, with varying degrees of success, have been reported for the treatment of iris cysts. Surgical intervention remains the last option which can give a good functional outcome with minimal inflammatory complications, especially when less invasive options do not seem feasible due to the extensive nature of the cyst.

Secondary iris cyst following ocular blunt trauma: A case report

We present an uncommon case of a post-traumatic iris cyst following blunt trauma with secondary glaucoma. A 19-yr-old male presented with hyphaema and redness in the right eye. Slit-lamp examination and ultrasound biomicroscopy were consistent with an inferior iris cyst. Intraocular pressure was raised, and angle recession was present in the nasal quadrant on gonioscopy which made us probe for blunt trauma history, which was present. With no other causative history or signs and ruling out ciliary body tumor using imaging, we made our diagnosis. Pressures were reduced with antiglaucoma medication. Though uncommon, blunt trauma should be considered as a cause after ruling out other causes, especially malignancy.

Long-term outcomes of \u201copen iridectomy\u201d for secondary anterior chamber epithelial iris cysts

Epithelial cysts run a high risk of recurrence and conversion to sheet-like ingrowth after surgical intervention. In this retrospective study, we introduced a modified iridectomy for treatment of secondary epithelial iris cysts (EICs) in the anterior chamber. Twenty-nine patients (29 eyes) aged 2–61 years received “open iridectomy” for EICs between April 1995 and July 2019. After viscodissection, most of the cyst wall was cut using a 20-gauge aspiration cutter via a 2.5-mm clear corneal incision. The residue closely adhering to the iris stroma was remained to avoid photophobia and diplopia. At 3 months, best corrected visual acuity was ≥ 20/100 in 55.5% (15/27, except two pediatric patients with poor cooperation) of patients. Among the eight patients suffering partial corneal edema preoperatively, six patients received surgery treatment at 3–6.5 months, and the cornea in the other two patients became transparent after medication. In a mean follow-up of 47.4 months, recurrence occurred in 3 patients at 7, 37, and 118 months, respectively. The percentage of treatment success was 96%, 87%, and 65% at 1, 5, and 10 years, respectively. “Open iridectomy” was effective for EICs, with a minimal invasion, less damage to the corneal endothelium, and a low recurrence rate.

Iris cyst after femtosecond laser-assisted cataract surgery: a case report

BackgroundSecondary iris cysts are uncommon complication after cataract surgery. The reports of an iris cyst after conventional phacoemulsification surgery are scanty, let alone the iris cyst following femtosecond laser-assisted cataract surgery (FLACS). We herein report an unusual case of an iris cyst after an uneventful FLACS.Case presentationA 64-year-old man who was healthy underwent FLACS for a moderate cataract of his left eye. Shortly after surgery, he achieved 20/20 vision, but anterior bowing of temporal iris was noted on postoperative day 9 with a retro-pupillary iris cyst at temporal-inferior quadrant found after pupil dilatation. The cyst was confirmed by ultrasound bio-microscopy afterward. Four weeks later, argon laser cystotomy was performed, and the cyst disappeared 3 days later. The patient’s vision remained stable thereafter.ConclusionAlthough rare, secondary iris cyst may be one of the complications after FLACS. Argon laser cystotomy is effective in the management of post-FLACS iris cyst.

Iris cysts: Varied presentations and review of literature.

An iris cyst is a nonkeratinized squamous epithelial-lined space involving a layer of iris. The presentation of iris cyst can be variable-innocuous or presenting with secondary complications. The identification of whether the cyst is primary or secondary is important. The prognosis of primary iris cysts is good, as the majority does not require treatment and that of secondary iris cysts is much more capricious depending on their presentation. Their optimal management often poses a challenge for ophthalmologists. Here, we will present two cases of iris cysts with diverse presentation along with a review of the literature of this rare clinical entity.

Atypical iris cyst after trauma and cataract surgery masquerading as iris tumor

A 22-year-old man was referred for gradually impaired vision in his left eye. The affected eye had a history of traumatic ruptured cornea with a primary repair 2 years ago and then a cataract surgery 6 months later. At presentation, a large whitish iris mass was seen on the superior part of the iris involving the visual axis in the affected eye. The anterior segment optical coherence tomography revealed an iris cyst with solid contents. The entire cyst was removed surgically. The histological finding was consistent with an iris cyst lined by stratified squamous epithelium. At 1-year postoperatively, there was no sign of recurrence. Secondary iris cyst, from epithelial downgrowth, which occurs after trauma and cataract surgery, can atypically masquerade as an iris tumor. Surgical removal is indicated if the vision is threatened and to provide a definite histopathological diagnosis.

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.

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.

Successful Management of Secondary Iris Cysts With Viscoelastic-Assisted Endophotocoagulation

Successful Management of Secondary Iris Cysts With Viscoelastic-Assisted Endophotocoagulation

Management of Lens Dislocation and Iris Cyst After Iris Sutured Intraocular Lens Implantation in Children With Marfan Syndrome

The authors describe two brothers with Marfan syndrome who developed severe complications after iris-suture fixation of an intraocular lens (IOL). A secondary iris cyst developed in one and the IOL dislocated into the vitreous in the other, requiring pars plana vitrectomy and IOL removal. Although the visual outcome was good in both cases, severe complications of iris-suture fixated IOLs must be considered when surgical correction of aphakia is attempted in children with Marfan syndrome.

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.

Iris cysts in children: classification, incidence, and management

BACKGROUNDIris cysts in children are uncommon and there is relatively little information on their classification, incidence, and management.METHODSThe records of all children under age 20 years who were diagnosed with...

Primary iris cysts: a review of the literature and report of 62 cases.

The authors present their experience with the evaluation and follow-up of 62 patients with primary cysts of the iris, discuss their clinical and pathological features, and propose a simple classification for these lesions. The results suggest that the great majority of primary iris cysts, particularly those which arise from the iris pigment epithelial layers, are stationary lesions which rarely progress or cause visual complications. This finding is contradictory to the belief of certain authorities who stress that many such lesions lead to severe complications, with blindness and loss of the eye. The natural course of primary epithelial cysts differs from that of secondary iris cysts which follow surgical or nonsurgical trauma. The latter lesions do frequently enlarge and lead to severe complications such as inflammation and glaucoma. The major clinical importance of primary iris cysts lies in their similarity to neoplasms of the iris and ciliary body. It is concluded that the great majority of them are ophthalmic curiosities which require no treatment.