Primary iris stromal cyst with rapid growth.

PURPOSE: To describe the clinical features and the surgical management of primary iris stromal cyst with rapid growth. METHODS: A 14-year-old Chinese-Mongolian girl was referred to us with a 1-month history of obstructed vision and photophobia. On an examination, a semitransparent cyst with a densely pigmented posterior wall was revealed in the anterior chamber of the left eye. The information regarding the location and extent of the cyst was further analyzed by anterior segment optical coherence tomography and ultrasound biomicroscopy. It arose within the iris stroma, measuring 7.52 x 3.60 mm. Blood vessels on the surface of the lesion were revealed by iris angiography. There was no history of amniocentesis, birth trauma, antecedent ocular injury, or maternal illness during gestation. The diagnosis of primary iris stromal cyst was made. A combination of needle aspiration, piecemeal resection of cyst wall, cryotherapy, and argon laser photocoagulation with overlapped spots was used. RESULTS: Histopathology of the cyst wall revealed nonkeratinized, multilayered, stratified squamous epithelium with clusters of goblet cells. Complete resolution of the cyst was successfully achieved. The visual acuity improved to 20/25 from counting fingers. At 6 months of follow-up, there was no recurrence. CONCLUSIONS: Complete eradication and devitalization of any remaining epithelial cells are the key factors for preventing recurrence and diffuse epithelialization of the anterior chamber.

Transpupillary argon laser photocoagulation and Nd:YAG laser cystotomy for peripheral iris pigment epithelium cyst.

PURPOSE: To report the use of a combination of transpupillary argon laser photocoagulation and Nd:YAG laser cystotomy in the treatment of peripheral iris pigment epithelium (IPE) cyst. DESIGN: Case report. METHODS: A 23-year-old man presented with a one-month history of blurred vision and pain in the right eye. Slit-lamp biomicroscopy and gonioscopy revealed, in the iridociliary sulcus, a large clear IPE cyst, which was demonstrated by ultrasound biomicroscopy (UBM). A combination of transpupillary photocoagulation to devitalize the epithelial lining and neodymium-doped yttrium aluminum garnet (Nd:YAG) laser cystotomy to drain the cyst was engaged. RESULTS: Laser treatment resulted in vanishing of the cyst and disappearance of the subject symptoms. Two months postoperatively, no evidence existed of the iris pigment cyst regrowth. CONCLUSIONS: The minimal invasiveness of the combination of transpupillary laser photocoagulation and cystotomy yielded a favorable result. This procedure may be an alternative to conservative regimen if IPE cyst is clearly defined and readily seen.