Massive iris cyst in an adult female

To report an interesting case of a massive iris cyst encompassing nearly the entire anterior chamber in an adult female years after cataract surgery.

A 77-year-old female with a history of bilateral cataract surgery presented with a large ciliary body mass in the left eye. The lesion was first incidentally noted one year prior to presentation and continued to grow and ultimately caused complete obstruction of the visual axis. Per report, the patient received two YAG laser treatments with subsequent recrudescence. Exam on second opinion consultation with our service was significant for a cystic mass involving nearly the entire left anterior chamber with total occlusion of the pupil. Patient underwent surgical excision with ethanol irrigation and partial iridectomy. The pathology report revealed benign stratified non-keratinizing squamous epithelium consistent with benign epithelial cyst and favoring iris stromal cyst. Post-operative course was complicated by corneal edema and elevated intraocular pressure.

We describe a case of iris implantation cyst that is unique in several aspects, including the size of the mass encompassing nearly the entire anterior chamber, its presentation in an adult years after cataract surgery, rapid growth across one year, and the severe degree of visual compromise.