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Primary iris stromal cyst with rapid growth
Yang Xiao1, Yu-Hong Wang, Gai-Ling Niu
1Department of Ophthalmology, Beijing Chaoyang Hospital (West Campus), Affiliate of Capital Medical University, Beijing, People's Republic of China. xiaoyangmd@yahoo.com.cn
Insights
This study details the successful surgical management of a rapidly growing primary iris stromal cyst. The treatment ensured complete cyst resolution and improved vision, with no recurrence at six months.
Area of Science:
- Ophthalmology
- Surgical Management
- Anterior Segment Pathology
Background:
- Primary iris stromal cysts are rare ocular tumors.
- Rapid growth can lead to significant visual impairment.
Observation:
- A 14-year-old presented with vision obstruction and photophobia due to a large iris stromal cyst.
- Anterior segment OCT and ultrasound biomicroscopy confirmed the cyst's size and location.
- Iris angiography revealed vascularization of the cyst surface.
Findings:
- Histopathology showed stratified squamous epithelium with goblet cells.
- A combined surgical approach (aspiration, resection, cryotherapy, laser) achieved complete cyst eradication.
- Visual acuity improved significantly, and no recurrence was observed at 6 months.
Implications:
- Complete removal of epithelial cells is crucial for preventing recurrence.
- This multidisciplinary surgical approach offers a viable solution for primary iris stromal cysts.
- Effective management can restore visual function and prevent long-term complications.
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.
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