Laser puncture of symptomatic primary iris pigment epithelial cyst causing hemeralopia: a rare case
Primary iris pigment epithelium cysts involve posterior surface of the iris and can occur at pupillary margin or anterior ciliary body. They may be stationary or progressive and sometimes regress spontaneously. These cyst can occasionally lead to angle-closure glaucoma, plateau iris syndrome and secondary pigment dispersion syndrome. A steadily growing cyst may disturb the vision by covering the visual axis and provoke an increase in intraocular pressure (IOP) or even inflammation if it touches the corneal endothelium. There are multiple management options in complicated situations. We report a case of a 17-year-old girl with unusual complaints of hemeralopia and dark-brown discolouration of pupils in both eyes. On examination, she had multiple pigment epithelial iris cysts at the pupillary margins, which were punctured with Nd:Yag laser, and the response was improvement in vision and hemeralopia without any pigment dispersion or IOP changes.
Lois N, Shields CL, Shields JA, Mercado G. Primary cysts of the iris pigment epithelium. Ophthalmology. 1998;105:1879-1885.
Vela A, Rieser JC, Campbell DG. The heredity and treatment of angle-closure glaucoma secondary to iris and ciliary body cysts. Ophthalmology. 1984;91:332-337.
Alward WL, Ossoinig KC. Pigment dispersion secondary to cysts of the iris pigment epithelium. Arch Ophthalmol. 1995;113:1574-1575.
Lewis RA, Merin LM. Iris flocculi and familial aortic dissection. Arch Ophthalmol. 1995;113:1330-1331.
Yanoff M, Zimmerman LE. Pseudo melanoma of anterior chamber caused by implantation of iris pigment epithelium. Arch Ophthalmic. 1965;74:302-305.
Kawaguchi K, Yamamoto S, Nagae Y, Okada AA, Iwasaki N, Tano Y. Treatment of recurrent giant iris cyst with intracyst administration of mitomycin C. Br J Ophthalmol. 2000;84:800-801.
Tsai JC, Arrindell EL, O’Day DM. Needle aspiration and endodiathermy treatment of epithelial inclusion cyst of the iris. Am J Ophthalmol. 2001;131:263-265.
Kuchenbecker J, Motschmann M, Schmitz K, Behrens-Baumann W. Laser iridocystotomy for bilateral acute angle-closure glaucoma secondary to iris cysts. Am J Ophthalmol. 2000;129:391-393.
Verma L, Venkatesh P, Sen S, Lakshmaiah NC, Tewari HK. Surgical removal of a free floating cyst of the iris pigment epithelium causing disturbing visual symptoms. Ophthalmic Surg Lasers. 1999;30:223-225.
Behrouzi Z, Khodadoust A. Epithelial iris cyst treatment with intracystic ethanol irrigation. Ophthalmology. 2003;110:1601-1605.
Copyright (c) 2020 Ram Lal Sharma, Mohan Lal Pandey, Vinod Sharma, Kalpana Sharma, Neha chaudhary
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