The Diagnostic and Therapeutic Challenges of Posttraumatic Iris Implantation Cysts: Illustrative Case Presentations and a Review of the Literature

Figure 1

Clinical and diagnostic images from case 1: initial presentation. (a) Slit-lamp photograph of the patient’s right eye upon presentation two years after his initial penetrating ocular injury with a wire fence. An inferocentral corneal scar is seen (asterisk). The pupil is irregular with a large, opaque, iris cyst extending from 7 to 9 o’clock with two embedded cilia (arrows). The lens is clear with no signs of cataract formation. (b) Anterior segment optical coherence tomography (AS-OCT) images illustrating the healed corneal laceration (arrow) from the patient’s prior penetrating ocular injury and the location and contours of the iris implantation cyst. The cyst abuts the posterior cornea and there is absence of normal angle architecture. High reflectivity within the cyst indicates that the lesion is unlikely to be fluid-filled. (c) Slit-lamp photograph of the patient’s eye one week after debulking of the cyst and injection of 5-Fluorouracil (5-FU) within the cyst cavity. The cyst was approached through a temporal scleral tunnel incision to facilitate precise entry into the body of the cyst for drainage and prevent expulsion of debris into the anterior chamber. Following surgery, the cyst initially resolved and there is rounding of the pupil.

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