Tratamiento quirúrgico conservador en un caso de quiste de iris postraumático

Abstract

RESUMENCaso clínico: Varón de 32 años aquejado de pérdi-da visual en ojo derecho (OD) secundario a un quiste que ocupa la mitad de la cámara anterior, diagnosticado clínicamente de quiste secundario epitelial de iris. Tres años antes había sufrido un traumatismo penetrante. Se realiza aspiración con aguja, viscodisección y fotocoagulación ab externo, logrando una rápida recuperación visual sin secuelas funcionales ni anatómicas. A los seis meses la agudeza visual permanece estable sin recidiva de la lesión. Discusión: El manejo quirúrgico conservador mediante aspiración y fotocoagulación en este caso fue eficaz y seguro en el tratamiento del quiste epitelial adquirido de iris.Palabras claves: Quiste de iris, traumatismo penetrante, aspiración y fotocoagulación, tratamiento quirúrgico conservador. COMUNICACIÓN CORTA ABSTRACTCase report: A 32-year-old man with recent visual loss in his right eye, was found to have an iris cyst involving about 50% of the anterior chamber. He had been treated three years previously for a penetrating injury to that eye. The cyst was treated by aspiration, viscodissection and ab-externo photocoagulation, with this achieving a rapid recovery of vision and good anatomic results. At the six month follow-up visit the visual acuity remains stable with no signs of recurrence of the cyst. Discussion: Conservative surgical treatment consisting of aspiration, viscodissection and photocoagulation appears to be an effective strategy to manage secondary anterior chamber cysts, achieving good anatomic and functional results (Arch Soc Esp Oftalmol 2007; 82: 455-458).

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

“…This method has limitations due to the difficulties in cyst walls visualization, adverse effects in treatment of large cysts, a risk of the cyst wall breaking, or its recurrence and excessive growing of epithelium in the anterior segment [11,26]. After photocoagulation of iris cysts some complications may occur, for example uveitis, ocular pain, forming of posterior synechiae, and rise of intraocular pressure [12,14]. Some authors report good effects using iris cyst photocoagulation [22,23], but it is ineffective in cases of large cysts located near the endothelium [27], which was presented in our patient’s case.…”

“…They can be also associated with metastases or parasites [9,10]. Small cysts that do not grow should be controlled, and they do not require any treatment; however, it may be necessary to perform surgical treatment to remove medium or large cysts, as complications may occur [11], including corneal edema, uveitis, glaucoma, worsening of the visual acuity in some cases due to overlapping of the pupil, cataract and ocular pain [5,12–17]. …”

Surgical Management of Post-Traumatic Iris Cyst

“…These cysts develop from epithelial cells of the cornea or conjunctiva that have been implanted or transplanted on the iris through the wound [ 3 ]. These cells in the anterior chamber then grow into a sheet or form a cyst [ 4 ]. Traumatic iris cysts are of two types: the “solid-looking” cyst or pearl cyst has stratified or cubical epithelium lining the cyst wall; the second type is, called the serous cyst, contains straw colored turbid fluid [ 5 ].…”

“…However, larger iris cysts can grow in size, and cause pupillary block and secondary glaucoma, uveitis, corneal decompensation and eventually, a painful, blind eye [ 1 , 6 , 7 ]. Many different modalities of treatment, ranging from minimally invasive techniques like aspiration of the cyst and laser therapy, to aggressive surgical procedures like block excision have been described for the management of iris cysts [ 4 ]. The purpose of this work is to describe the management of a post-traumatic iris cyst by surgical excision of the cyst in toto, which achieved a good functional outcome with no significant inflammatory complications.…”