Recurrent Iris Cyst: Treatment Challenges and Outcomes: A Case Report

Introduction Iris cysts are rare anterior segment pathologies, accounting for about 21% of all iris tumors. They are classified into primary cysts (usually asymptomatic and originating from the pigment epithelium) and secondary cysts (which can result from trauma, surgery, or infections)(1). Recurrent cysts may cause complications such as inflammation, glaucoma, corneal edema, or visual impairment. Diagnostic tools include biomicroscopy, OCT, and UBM(2). This case report discusses a recurrent iris cyst and highlights the treatment challenges. Case Presentation A 65-year-old patient presented with a bright mass in the left iris. UBM revealed a thin-walled cyst in the inferiorlateral quadrant, measuring 4.45 x 2.8 x 5.87 mm. Initially, observation was chosen, but over two years, due to cyst growth, four Nd:YAG laser punctures were performed. Surgical intervention was postponed. The cyst decreased in size after each procedure with no inflammatory reactions, though recurrence remains possible. Visual acuity, corneal status, intraocular pressure, and signs of inflammation were regularly monitored. Discussion Management of recurrent iris cysts poses clinical challenges due to complications such as visual impairment, corneal endothelial decompensation, and secondary glaucoma. Nd:YAG laser puncture is effective in reducing cyst size but does not always prevent recurrence. Long-term follow-up is essential to detect cyst growth and complications in time(3). If the laser procedure is insufficient, additional treatments like mitomycin-C injections or surgical interventions (iridectomy and iris plasty) may be considered(4). Proper treatment selection, continuous monitoring, and timely surgery are necessary to prevent complications and ensure long-term success(5). Conclusions An individualized approach and continuous monitoring are essential in managing iris cysts. Nd:YAG laser puncture reduces cyst size, but recurrence is likely. Surgical intervention should be considered when necessary to prevent complications and ensure long-term outcomes.