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Abstract
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.
References
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Figure 1.
(A) A 27-year-old man with a free floating pigmented mass in the right eye. (B) There was a mass floating in the anterior chamber, near the pupil margin. It was shown ovoid, brownish in color consisted of semi-translucent membrane.
Figure 2.
(A) Paracentesis was performed through the a clear cornea at 12 o’clock using a slit knife. (B) A 27-gauge bent needle tip was inserted underneath the pigmented iris cyst. Viscoelastic substance (Healon®) was instilled into the anterior chamber. (C) The pigmented iris cyst spontaneously extruded out through the opening.(white arrow indicates the iris cyst)
Figure 3.
(A) Hematoxylin-eosin stain, ×40. On low magnititude power, section shows a folded benign epithelial cyst having profuse black pigmentation, partially papillary architecture of epithelial layer is noted. There is no evidence of malignant feature.(B) Hematoxylin-eosin stain, ×400. On high magnititude power, the epithelial cells are arranged in regular order. There cells show monotonous shape, size and abundant melanin pigment granule. There is no evidence of atypical pleomorphic cell or mitosis.
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