Treatment of Recurred Iris Cyst with Laser Photocoagulation and Cystotomy

Ho Sung Jin; Yong Hyun Kim; Il Suk Yun; Jae Hong Ahn

doi:10.3341/jkos.2016.57.1.145

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Jin, Kim, Yun, and Ahn: Treatment of Recurred Iris Cyst with Laser Photocoagulation and Cystotomy

Original Article

J Korean Ophthalmol Soc 2016;57(1):145-149.

Published online: 31 August 2016

DOI: https://doi.org/10.3341/jkos.2016.57.1.145

Treatment of Recurred Iris Cyst with Laser Photocoagulation and Cystotomy

Ho Sung Jin, M.D, Yong Hyun Kim, M.D, Il Suk Yun, M.D, Jae Hong Ahn, M.D, PhD

Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea

Address reprint requests to Jae Hong Ahn, MD, PhD Department of Ophthalmology, Ajou University Hospital, #164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: 82-31-219-5255, Fax: 82-31-219-5259 E-mail: chrisahn@ajou.ac.kr

‗ This study was presented as a poster at the 113th Annual Meeting of the Korean Ophthalmological Society 2015.

Received 19 June 20151 September 2015 Accepted 25 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of recurred iris cyst 11 years after treatment with endodiathermy, which was treated with laser photo-coagulation 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 examina-tion showed an iris cyst adjacent to the nasal corneal limbus. The cyst was filled with turbid fluid. It distorted the pupil and threat-ened visual axis. Iris cystotomy (diameter larger than 500 μ m) was done with diode laser photocoagulation and a neodymium- doped yttrium aluminium garnet laser. At the same day, the patient’s intraocular pressure elevated to 50 mm Hg in spite of max-imal 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.

Keywords: Cystotomy, Laser photocoagulation, Recurred iris cyst, Secondary ocular hypertension

References

1. Shin JH, Park HY, Cho SJ. Free-floating pigmented iris cyst in the anterior chamber. J Korean Ophthalmol Soc. 2008; 49:1862–6.

2. Shields JA, Kline MW, Augsburger JJ. Primary iris cysts: a review of the literature and report of 62 cases. Br J Ophthalmol. 1984; 68:152–66.

3. Lois N, Shields CL, Shields JA, Mercado G. Primary cysts of the iris pigment epithelium. Clinical features and natural course in 234 patients. Ophthalmology. 1998; 105:1879–85.

4. Kim MS, Jin KH, Kim DH. A case of bilateral iris cyst. J Korean Ophthalmol Soc. 2005; 46:1252–6.

5. Rao A, Gupta V, Bhadange Y. . Iris cysts: a review. Semin Ophthalmol. 2011; 26:11–22.

6. Lee SS, Yoo SJ, Kim BY. Laser treatment for recurrent secondary iris cyst. J Korean Ophthalmol Soc. 2004; 45:146–51.

7. Shields JA. Primary cysts of the iris. Trans Am Ophthalmol Soc. 1981; 79:771–809.

8. Lois N, Shields CL, Shields JA. . Primary iris stromal cysts. A report of 17 cases. Ophthalmology. 1998; 105:1317–22.

9. Capó H. Palmer E. Nicholson DH. Congenital cysts of the iris stroma. Am J Ophthalmol. 1993; 116:228–32.

10. Guerry D, Wiesinger H. Spontaneous cyst of the iris stroma. Am J Ophthalmol. 1957; 44:106–7.

11. Sugar HS, Blau RP. Free-floating cysts of the ocular media. Ann Ophthalmol. 1973; 5:445–8. passim.

12. Tsai JC, Arrindel EL, O’Day DM. Needle aspiration and endodia-thermy treatment of epithelial inclusion cyst of the iris. Am J Ophthalmol. 2001; 131:263–5.

13. Cho BJ, Kwon OW, Kim HB. Chen KH. Iris cyst treated with bipo-lar endo-diathermy. J Korean Ophthalmol Soc. 1985; 26:793–7.

14. Sugar J, Jampol LM, Goldberg MF. Argon laser destruction of an-terior chamber implantation cysts. Ophthalmology. 1984; 91:1040–4.

15. Fine BS. Free-floating pigmented cyst in the anterior chamber. A clinicohistopathologic report. Am J Ophthalmol. 1969; 67:493–500.

Figure 1.

Treatment of primary iris cyst with endodiathermy. (A) A primary iris cyst was discovered in September 1996. (B) As the iris cyst proliferated and extended, it distorted and threatened the visual axis in December 2002. (C) Postoperative finding at 4 months after removal of the iris cyst with endodiathermy.

Figure 2.

Treatment of recurred iris cyst with diode laser. (A) Photograph showing iris cyst before laser treatment. (B) Corneal en-dothelial cell count before laser treatment. (C) Photograph taken 6 months after laser treatment. Iris cyst is adhered to the corneal endothelium and shrunken. (D) Corneal endothelial cell count 2 months after laser treatment.

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