Photocoagulation of large iris cysts

Large epithelial iris cysts, whose anterior walls are in contact with the corneal endothelium, are difficult to treat. Initial surgical decompression with later argon laser photocoagulation has been advocated, but the attendant complications are many. In four patients, we barraged the posterior wall of the cyst and the surrounding iris with the argon laser. The cyst was then collapsed using the argon or neodymium-yttrium aluminum garnet laser, and the anterior wall, which fell away from the cornea, was then photocoagulated. No recurrences or untoward sequelae were seen on follow-up. We recommend this noninvasive technique for all large iris cysts.