[Intrastromal epithelial cysts of the iris: two case studies]. / Kyste congénital du stroma irien.

AIM: Intrastromal epithelial cysts, congenital or acquired, are rare tumors of the anterior chamber. We report two cases, one in a 4-Month-old girl and one in a 14-Year-old teenage girl. MATERIAL AND METHODS: In the infant case, a large cyst with a superior base obstructed the visual axis. The child had already developed amblyopia and intermittent esotropia, with normal ocular pressure. Aspiration of the cyst with complete excision was done without iridectomy. Two Years later, a secondary corectopia required an inferior iridectomy. Finally, 4 Years later, endophthalmitis developed on a corneal stitch, and the eye was enucleated. In the second case, the teenage girl had noticed a modification in her iris due to an inferior temporal iris cyst. The cyst was excised with a peripheral iridectomy. Despite a first complete excision, a recurrence the following Year was treated by Yag laser. One Year later, the clinical aspect was stable. COMMENTS AND CONCLUSION: These benign tumors present the problem of local extension and recurrence. Surgical treatment with iridectomy is often proposed despite eventual aesthetic or functional consequences. Yag laser may be a therapeutic alternative. The two operations reported here did not prevent recurrence. In conclusion, intrastromal epithelial cysts of the iris are rare and benign tumors that may induce local complications and lead to recurrence. Many treatments can be discussed for each case.

[Ocular complications of porphyria. A case of Günther's disease]. / Complications oculaires des porphyries. A propos d'un cas de maladie de Günther.

On a case of Günther congenital porphyria with late ophthalmic complications, the authors study clinical and haematological manifestations of this disease (clinical signs are related to light sensibilisation: sclerodactily, hyperpigmentation, non cicatrisating wounds, long standing scars of reposed areas; they begin in the early childhood by hemolytic anemia and emission of dark port urines too). The various porphyries are then studied and their ophthalmologic signs are related either to the light sensibilisation either to angiopathy and neuropathy (acute porphyria). These are always spontaneously reversible after the acute onset; on the contrary, light sensibilisation involvements go worth and worth and in some cases (Günther disease; late cutaneous porphyria) induce irreversible damages: they begin by eyelids and conjunctival scars then involve scleral and corneal tissues (scleral malacia perforans). In fact, they have a bad prognosis: ophthalmologic surgical repair, after a little success, fails, because of the non cicatrisating tissues. Best treatment is preventive: --in case of light sensibilisation: eviction of sunlight or light sensibilisating drugs; --in case of acute porphyria: eviction of some drugs (barbiturates); surgical action.