Two different modalities for treating iris cysts

AbstractPurposeTo present two patients with recent onset iris cysts where two different treatments were applied.MethodsWhile generally benign, stromal iris cysts can increase in size very rapidly and if treatment is not prompt, can result in enucleation,as in traumatic related induced epithelial cysts. To avoid this, two different treatment modalities were performed in our clinic. The first case was a traumatic iris cyst and the second case was a congenital cyst; they underwent intralesional photocoagulation and intralesional alcohol injection (Shields method) respectively.ResultsFor the first case of the patient, a 38‐year‐ old man with a secondary traumatic epithelial cyst, intralesional photocoagulation was performed over 270 degrees. The cyst shrivelled, and postoperatively the visual acuity increased from finger counting to 0.3. This was followed by a cataract surgery. In the months after the cataract surgery, the cornea became oedematous and the IOP elevated. After further decompensation, the patient elected to abstain from further surgery. In the second a 19‐year‐old man, with a congenital stromal cyst and progressive myopia was treated with intralaesional absolute alcohol. After the first treatment session, the cyst appeared to resolved but after several months it returned. A second intralesional alcohol treatment session was performed and while there is some return of fluid in the cyst this is accumulating very slowly. The patient remains symptom free for the past 2 years, the pupillary zone remains clear of the cyst and the visual acuity is 1.0 (Decimal Snellen).ConclusionsIn stromal iris cyst, the very rapidly progression can be blocked or stabilized by intralesional photocoagulation or alcohol. In our experience with these cases, the latter approach demonstrated better results in the long‐term and enucleation could be avoided.CL Shields S Aregalli ,EB Lally,SE Lally, JA Shields: Iristromal cyst management with absolute alcohol induced sclerosis. JAMA Ophthalm 2014,132,(6) 703‐708.