Management and surgical intervention of recurring iris cysts in an iris-claw phakic intraocular lens: detailed case report

Introduction: Phakic intraocular lenses (pIOLs) are well recognized for effectively correcting high refractive errors; however, rare complications such as iris cysts may significantly compromise outcomes. To the authors' knowledge, this case is unique because it is the first documented instance of a recurrent iridociliary cyst associated with an iris-claw pIOL, adding important insights into the potential for such complications and emphasizing the need for meticulous postoperative monitoring. Patient and Clinical Findings: A 54-year-old woman with a longstanding iris-claw pIOL presented with fluctuating visual acuity. Clinical evaluation revealed a recurrent iridociliary cyst that had progressively displaced the implant, resulting in intermittent vision loss and mechanical distortion of the pIOL. Diagnosis, Intervention, and Outcomes: The primary diagnosis was a recurrent iridociliary cyst causing displacement of the iris-claw pIOL. Initial management with cyst drainage and ablation provided only temporary relief, as the lesion recurred. Definitive surgical intervention, including complete cyst excision, repositioning of the pIOL, and subsequent cataract extraction, was required. These interventions stabilized the patient's visual acuity, with no recurrence of the cyst at final follow-up. Conclusions: This case underscores the critical importance of early detection, vigilant postoperative assessment, and timely surgical intervention in managing iris cysts associated with iris-claw pIOLs to preserve long-term visual function.