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

PURPOSE: We report a case of spontaneous recovery of an iris cyst with only tuberculosis medication and conservative eye drops when uveitis and angle closure occurred because of a cyst in a patient with peritoneal tuberculosis. CASE SUMMARY: A 49-year-old female who was diagnosed with iritis and treated with steroid eye drops visited our clinic because of decreased visual acuity 1 month prior. There were anterior chamber inflammation cells and an iris cyst completely obstructing the anterior chamber at 12 o'clock. At the time, the patient had been diagnosed with peritoneal tuberculosis in the Department of Internal Medicine and Gynecology and had been treated with surgery and medication. The patient had no past history of glaucoma, but when the iris cyst developed, the intraocular pressure increased to 29 mmHg and anterior inflammatory cells were seen in the range of +1 to +2. The primary lesion of tuberculosis improved and the iris cyst disappeared with treatments involving medication for tuberculosis, steroid eye drops, and glaucoma eye drops, without invasive treatments such as alcohol curettage, laser treatment, or cyst resection. CONCLUSIONS: If an iris cyst is a new lesion of the eye, it is necessary to identify the pattern and cause of the iris cyst first, and if a secondary benign iris cyst is suspected, the primary treatment of the causative disease is necessary rather than prompt invasive treatment.

Treatment of Recurred Iris Cyst with Laser Photocoagulation and Cystotomy

PURPOSE: To report a case of recurred iris cyst 11 years after treatment with endodiathermy, which was treated with laser photocoagulation and cystotomy followed by intraocular pressure elevation and underwent anterior chamber irrigation. CASE SUMMARY: A 46-year-old female presented to our department with decreased vision in her left eye that had persisted for several months. The patient had a history of surgical removal of an iris cyst with endodiathermy 11 years ago. Slit lamp examination showed an iris cyst adjacent to the nasal corneal limbus. The cyst was filled with turbid fluid. It distorted the pupil and threatened visual axis. Iris cystotomy (diameter larger than 500 microm) was done with diode laser photocoagulation and a neodymiumdoped yttrium aluminium garnet laser. At the same day, the patient's intraocular pressure elevated to 50 mm Hg in spite of maximal conservative treatment and went through anterior chamber irrigation. After six months, the iris cyst was adhered to corneal endothelium and disappeared. Visual acuity and intraocular pressure was within normal range. CONCLUSIONS: An iris cyst can recur after treatment with endodiathermy. Recurred iris cyst can be successfully treated with laser photocoagulation and cystotomy. However, turbid fluid inside the cyst may outflow to the anterior chamber and cause secondary ocular hypertension after treatment, so careful observation is needed.

Free-floating Pigmented Iris Cyst in the Anterior Chamber

PURPOSE: The aim of this project is to report the successful removal of a free - floating pigmented iris cyst in a patient ' s anterior chamber, which was causing visual disturbance. CASE SUMMARY: A 27 - year - old man visited our hospital because of an intermittent visual disturbance in his right eye developed two months prior to admission. There was no history of ocular trauma, surgery, inflammation, or a general medical problem. On slit lamp examination, we found a free - floating translucent pigmented iris cyst, which was ovoid in shape and about 3 mm in size in the right eye near the pupil margin. Moving in the anterior chamber, the cyst caused visual disturbance because it partly covered the pupil. It was also near the endothelium. Through the clear cornea incision, the iris cyst was removed successfully. From histopathologic investigation of the cyst, the tissue was found to consist of mature pigment epithelium, including pigment granules CONCLUSIONS: A free - floating pigmented iris cyst in the anterior chamber generally does not result in any complications and maintains its condition stably without changing in size. Hence, as long as it does not cause complications, no treatment is necessary. However, if it causes visual disturbance or it damages endothelial cells or causes glaucoma or any other intraocular complication, it needs to be treated. In the case of our patient, visual disturbance did occur and we removed the iris cyst through an operation. Such a case has not been reported before in South Korea.

A Case of Bilateral Iris Cyst

PURPOSE: Iris cyst is a rare condition and there has been no Korean report of bilateral iris cyst. The authors present the first Korean report of a patient with bilateral iris cysts. METHODS: A 62-year-old man presented with intermittent visual field disturbance of the left eye when exposed to bright light. The patient underwent visual field examination and slit lamp examination. On slit lamp examination, a dark-brown mass was revealed along the lateral pupillary margin in the left eye. In the right eye, the shape of the iris was convex at the 8 o'clock direction. Ultrasound biomicroscopy, confirmed the presence of a mass. RESULTS: The patient showed no specific abnormality in visual field examination. Ultrasound biomicroscopy showed the objects to be cystic, with a thin-walled homogenous hypoechoic lesion on the posterior surface of the iris in both eyes. There were two cysts in each eye measuring 4.35 mm x 1.13 mm and 1.47 mm x 1.11 mm in the left eye, and 1.05 mm x 1.02 mm and 1.90 mm x 1.05 mm in the right eye. CONCLUSIONS: Asymptomatic iris cyst does not need to undergo treatment, but careful examination is nevertheless required required at regular intervals in case a complication develops.

Laser Treatment for Recurrent Secondary Iris Cyst

PURPOSE: To report two cases of recurrent iris cyst, that were treated with argon laser photocoagulation and Nd: YAG laser cystotomy. METHODS: A 56 year-old woman with a history of cataract surgery and trabeculectomy in the right eye 15 months ago was presented with ocular irritation and decreased vision, and a 34 year-old man with a history of ocular trauma in the right eye 10 years ago was presented with photopsia and decreased vision. The recurrent secondary iris cyst was diagnosed in both patients. Argon laser photocoagulation and Nd: YAG laser cystotomy used to coagulate the cysts under the topical anesthesia. After 15 months, recurrent iris cyst developed at the same site of the second patient. The argon laser photocoagulation and Nd: YAG laser cystotomy were repeated. RESULTS: The treatment with argon laser photocoagulation and Nd: YAG laser was effective for the resolution of the recurrent secondary iris cysts.

Iris Cyst: A case report

Cysts of the iris may be primary lesions of either epithelial or stromal in origin, or secondary lesions after trauma or surgery. The stromal cyst is usually of primary lesion, although it could be secondary as shown in our case. We report a case of recurrent iris cyst after trauma. The patient was an 8-year-old girl. She had a penetrating injury of the involved eye three years ago. She had a similar iris cyst removed two years before this surgery. Histologically, the cyst was lined by non-keratinizing stratified squamous epithelia and subjacent fibrovascular tissue. Islands of melanin-containing epithelial cells and acellular basophilic degenerating materials were also seen in the lesion. This case represents a stromal epithelial cyst that by history appears to be of post-traumatic etiology.