The Diagnosis and Treatment of a Post-traumatic Iris Cyst Referred as an Iris Tumor

Purpose: We report the diagnosis and treatment of a secondary iris cyst in a patient referred for an iris tumor.Case summary: A 29-year-old man diagnosed with an anterior chamber mass of the left eye was referred to our center for further evaluation and management. Twenty years previously, he suffered a penetrating ocular injury of his left eye and underwent primary closure. He had no underlying systemic disease. At his initial visit, the best corrected visual acuity of his left eye was 0.5. A whitish-gray mass was observed within the anterior chamber from 1 o'clock to 5 o'clock, obscuring the pupil. Anterior segment optical coherence tomography revealed a cystic mass touching the retrocorneal surface. No other lesions were seen on orbital imaging or ocular ultrasonography. Ultimately, it was diagnosed as an iris cyst that occurred secondary to ocular trauma. After needle aspiration and intracystic injection of 99% ethanol, the cyst collapsed fully. However, a cataract developed within a few months, and phacoemulsification and intraocular lens implantation were performed. Seven months after cyst aspiration, the uncorrected visual acuity of the left eye had recovered to 0.5. The cyst still adhered to the corneal endothelium, remaining in its collapsed state. The current corneal endothelial cell density is 871 cells/mm2.Conclusions: A secondary iris cyst was diagnosed in a patient with a history of penetrating eye trauma and surgery. It was treated successfully with needle aspiration and intracystic alcohol injection.