The development of iris cysts along the pupillary border has been associated with the topical administration of miotics. The incidence of these lesions is particularly high in young patients treated for accommodative esotropia with the long-acting cholinesterase inhibitors, eg, isofluorophate (Floropryl, DFP) and echothiophate iodide (Phospholine Iodide). A number of studies have been performed to elucidate the mode of action of these agents in the therapy of strabismus.1,2 These investigations have shown that the therapeutic effectiveness of the miotics in the management of esotropia cannot be accounted for on the basis of increased depth of focus resulting from pupil constriction. It should be possible, therefore, to use a mydriatic in conjunction with the miotic and still achieve the desired result. The preliminary clinical experiences of one of us (G. M. B.) have shown that a regimen of 10% phenylephrine (t.i.d.) with echothiophate tended to inhibit cyst formation.2
CHIN NB, GOLD AA, BREININ GM. Iris Cysts and Miotics. Arch Ophthalmol. 1964;71(5):611–616. doi:10.1001/archopht.1964.00970010627003
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