Surgical Management of Post-Traumatic Iris Cyst

Abstract

Purpose :Epithelial cysts of the iris may be primary or secondary. The management of secondary, posttraumatic iris cysts is often challenging. The purpose of this work is to report the successful surgical management of a post-traumatic iris cyst.Case Report:A 38 year-old man presented with an iris cyst associated with epithelial downgrowth and total cataract, six years after sustaining a penetrating injury to his right eye. The iris cyst was excised in toto with the epithelial downgrowth, and the procedure was combined with cataract extraction and intra ocular lens implantation. The patient had good post-operative visual recovery with minimal inflammatory reaction.Conclusion:Post-traumatic cysts of the iris can be associated with significant ocular morbidity. Many different modalities of treatment, with varying degrees of success, have been described for the treatment of iris cysts. Excision of the iris cyst in toto is a good surgical management option, which can result in an excellent functional outcome with minimal inflammatory complications.

Implantation Cyst of Anterior Chamber: A Case Report

“…Many different modalities of treatment, ranging from minimally invasive techniques like aspiration of the cyst and laser therapy, to aggressive surgical procedures like in toto surgical excision have been described for the management of anterior chamber cysts [ 16 ]. Less invasive successful treatment options for the management of anterior chamber implantation cysts have included aspiration of cyst contents and intralesional administration of mitomycin C. Conservative approaches include aspiration with or without cauterization, diathermy or iridectomy, injection of sclerosing agents, electrocautery, and photocoagulation [ 5 , 14 , 15 , 17 ].…”

“…As mentioned earlier, if the cyst is ruptured or part of the cyst wall is left behind, there is a high chance of recurrence or a postoperative inflammatory reaction. Conversely, aggressive surgical procedures aimed at complete eradication of the proliferative epithelial tissue are likely to produce significant collateral damage to the adjacent ocular structures, which in turn would result in a poor functional outcome [ 16 ]. The basic principle in the surgical management of secondary anterior chamber cysts seems to be removal of proliferative epithelial tissue that constitutes the cyst wall, via surgical excision or injection of cytoreductive agents, while minimizing collateral tissue damage [ 16 ].…”

“…Conversely, aggressive surgical procedures aimed at complete eradication of the proliferative epithelial tissue are likely to produce significant collateral damage to the adjacent ocular structures, which in turn would result in a poor functional outcome [ 16 ]. The basic principle in the surgical management of secondary anterior chamber cysts seems to be removal of proliferative epithelial tissue that constitutes the cyst wall, via surgical excision or injection of cytoreductive agents, while minimizing collateral tissue damage [ 16 ]. The clinician must weigh the options of total excision with higher likelihood of complications against a more conservative approach of aspiration with higher chance of recurrence.…”

Long-term outcomes of “open iridectomy” for secondary anterior chamber epithelial iris cysts

“…Conservative therapies for EICs, including Nd:YAG laser cystostomy 1 – 3 , needle aspiration alone 4 or combined with photocoagulation 5 , 6 or endodiathermy 7 , and intracystic irrigation 8 – 10 , may lead to uveitis, secondary glaucoma, and recurrence 11 , 12 . Aggressive surgical excision and devitalization of the epithelial tissues with vitrectomy, lensectomy or even full-thickness corneoscleral grafting 13 , 14 can damage ocular structures and also increase the risk of recurrence 15 , 16 .…”

Delayed Treatment of Secondary Iris Cyst due to Blunt Ocular Trauma

“…The iris cyst develops either from a break in the epithelium or iris stroma; aqueous humor then enters through this port de entrée and creates a space in between where the cyst will grow, eventually reaching the corneal endothelium and resulting in corneal edema [2][3][4][5]. Various surgical procedures for iris cysts have been reported and the result depends on the size of the cyst, the affected area of camera oculi anterior and prompt treatment [6][7][8][9].…”