To Report a case of Recurrence in post-traumatic Iris cyst with Traumatic cataract in 20 years old Young Male: A Multimodal Diagnostic and Surgical Approach

Abstract

Purpose: To report a case of recurrence in post-traumatic iris cyst with a related traumatic cataract in a young man, treated with a multimodal treatment regimen involving Deroofing of iris cyst, laser photocoagulation and adjunctive pharmacologic therapy.

Methods: A 20-year-old Male patient came with complaints of 6 months of redness, watering, foreign body sensation, and diminution of vision in the left eye. On examination, there was a translucent serous iris cyst along with traumatic cataract with blunt trauma to left eye 10 years ago. Imaging by ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) correlated the size and position of the cyst. Management involved are Deroofing of the anterior layer of iris cyst to maintain a round pupil and aspiration of the lens with foldable intraocular lens in the bag (IOL) implantation and for the recurrence of iris cyst with treatment of argon laser photocoagulation of the posterior pigmented layer of iris and intracystic injection of Mitomycin C.

Results: After 2-months follow-up patient with visual acuity improve from 6/60 to 6/9. But after 4 months there was a recurrence of the cyst clinically. The anterior segment was stable, free from any inflammation or complication.

Conclusion: Iris cysts after trauma should be treated by a stepwise, multimodal approach. Iris cysts after trauma should be treated with complete excision of the anterior and posterior layers of the iris cyst. But in this particular case we did Deroofing of anterior wall of iris cyst to save the pupil function as the patient was very young and with other stepwise treatment procedures but recurrence is seen maybe due to incomplete removal of cyst wall.