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December 1998

Congenital Cysts of the Iris Stroma

Arch Ophthalmol. 1998;116(12):1696. doi:10.1001/archopht.116.12.1696

CONGENITAL CYSTS of the iris stroma are rare and difficult to manage. We describe a 12-year-old girl complaining of unilateral painful eye with no history of trauma or previous surgery. Visual acuity was 20/20 OU. Slitlamp examination revealed mild conjunctival ciliary injection and a translucent cyst on the iris surface and iritis (Figure 1). The cyst was in contact with the corneal endothelium. It prevented visualization of the angle structures on gonioscopy. Intraocular pressure was 15 mm Hg OU. No other abnormalities were detected. Ultrasound biomicroscopy of the anterior chamber showed a large iris stromal cyst (Figure 2). Although there was sparing of the visual axis, surgery was performed be cause of a painful eye. The content of the cyst was aspirated and it was removed from the iris. Histological examination of the biopsy specimen showed cyst wall lined by squamous cell epithelium devoid of goblet cells (Figure 3). These suggest that the cyst, at the embryological stage, derived from surface epithelium entrapped within the eye at the time of the lens vesicle separation.1,2

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