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A 23-year-old man with a cystic iris lesion
Digital Journal of Ophthalmology 2008
Volume 14, Number 15
August 1, 2008
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Glenn W. Thompson | William Beaumont Hospital
Steven P. Dunn | Michigan Cornea Consultants
Diagnosis and Discussion
This is an example of a post-traumatic iris inclusion cyst, which are very difficult to treat and often recur. The proposed mechanism is invading epithelium from the conjunctiva or cornea having access to the anterior chamber through a traumatic or surgical wound. In addition, there are likely to be other factors which are not fully understood; there appears to be some cell-cell interactions that can both promote epithelial downgrowth as well as prevent it.(1)

Upon review of the literature, we decided to use the alcohol injection described by Behrouzi and Khodadoust.(2) Other possible treatment regimens have been described including cryotherapy, photocoaugulation, en-bloc excision, and Mitomycin C injection.(3-7) These are all viable options, and there are advantages and disadvantages to each. Given our patient's relatively good vision and lack of any painful symptoms, we decided to use a minimalistic approach initially. At the last follow-up the patient continued to do well; the cyst remained collapsed, and there was only minimal post-operative intraocular inflammation. If there is recurrence of the cyst, a different approach may be considered. The patient's visual acuity did show a line of improvement immediately after draining the cyst. However, the patient has now developed a posterior subcapsular cataract that is the most likely cause of his decreased vision, since the cornea remains clear, and the fundus appears normal without any clinical evidence of macular edema. Cataract extraction will be considered in the future after the patient has fully recovered from this cyst evacuation procedure.
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