A Case of Epithelial Inclusion Cyst of Iris

Abstract

To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.

The Diagnostic and Therapeutic Challenges of Posttraumatic Iris Implantation Cysts: Illustrative Case Presentations and a Review of the Literature

“…Smaller cysts can be merely observed over periods of time, but larger cysts often require expedited and aggressive treatment, especially when they cause complications such as persistent pain, obstruction of vision, iris bombe, pupillary obstruction, cataract formation, corneal decompensation, glaucoma, or uveitis. Unfortunately, despite treatment, long-term visual prognosis remains poor in many cases, largely in part due to cyst recurrence and secondary complications [ 1 , 3 , 29 – 31 ].…”

“…Intracystic injections of sclerosing agents or cytotoxic agents such as phenol, saline, iodine, 50% dextrose, ethanol, or mitomycin-C (MMC) can be used to halt cyst growth [ 1 , 36 – 39 ]. Argon laser photocoagulation and Nd:YAG laser iridocystotomy can be employed with the above methods to ablate and devitalize cyst wall epithelial cells, leading to cyst shrinkage [ 3 , 14 , 21 , 23 , 31 , 40 – 45 ]. Many of these conservative options are often used in combination to achieve maximal long-term success; however, recurrences can still occur [ 1 , 15 , 29 , 34 , 43 , 46 ].…”

Needle aspiration with surgical excision of an epithelial posttraumatic iris cyst – a case report

“…Multiple methods are suggested due to different degrees of aggravation of growing cysts, surgeon experience and other factors. Presented methods of treatment include en bloc remove, cyst removal using vitrectomy with cryodestruction, radiation, cyst removal with iridectomy [5,11] cyst aspiration without cauterization, aspiration with endodiathermy[18], cryoapplication [19], aspiration with iridectomy, alcohol or mitomycin injection into the cyst [20,21], photocoagulation [22,23], aspiration with photocoagulation of the cyst [13,14,24] or combinations of these techniques [24,25]. …”

Phacoemulsification in a Patient with Small Pupil and a Large Iris Cyst

“…Intracystic mitomycin injection has been reported for the treatment of secondary, posttraumatic iris cysts (3). Finally, argon laser photocoagulation has been employed as less invasive with fewer complications (4). Nevertheless, this technique carries significant risk of cyst ruptures (5).…”