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Recurrence of iris stromal cyst following aspiration and resection
Michael Casey1, Kenneth L Cohen, David K Wallace
1Department of Ophthalmology, University of North Carolina at Chapel Hill, USA.
Insights
Primary epithelial cysts of the iris stroma are rare in children. Surgical treatment for this amblyogenic cyst in a 3-month-old led to recurrence, glaucoma, and cataract, highlighting management challenges.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Ophthalmic Pathology
Background:
- Primary epithelial cysts of the iris stroma are uncommon, representing a small fraction of childhood iris cysts.
- These cysts, though rare, can possess amblyogenic potential, necessitating careful consideration for management.
- The rarity of these cases underscores the need for further clinical data and treatment strategies.
Observation:
- A 3-month-old infant presented with a primary epithelial cyst of the iris stroma.
- The cyst was deemed to have amblyogenic potential, prompting surgical intervention.
- Initial aspiration led to cyst recurrence within seven weeks.
Findings:
- A subsequent sector iridectomy with cyst excision also resulted in recurrence.
- The recurrent cyst led to the development of secondary glaucoma and cataract.
- This case illustrates the challenging and often complicated clinical course of iris stromal cysts.
Implications:
- Management of iris stromal cysts requires careful consideration of surgical timing and technique.
- Recurrence and severe complications like glaucoma and cataract pose significant challenges.
- Further research into effective treatment modalities for pediatric iris stromal cysts is warranted.
Abstract:
We describe a 3-month-old patient with a primary epithelial cyst of the iris stroma. Although these cysts account for 16% of all childhood iris cysts, these cysts are uncommon with only a small number of reported cases.(1-6) Because our patient's cyst had amblyogenic potential, we proceeded with surgical treatment. The cyst was aspirated, but it recurred within 7 weeks. Sector iridectomy with excision of the cyst was performed, again with recurrence and subsequent glaucoma and cataract. These cysts present difficult management issues concerning the choice of initial surgical treatment and subsequent complications.