Arnold Sam, Kim Eric, Derivaux Donald, Parker John S, Parker Jack S
Parker Cornea, Birmingham, AL, USA.
The University of Alabama School of Medicine, Birmingham, AL, USA.
Am J Ophthalmol Case Rep. 2022 Feb 11;26:101417. doi: 10.1016/j.ajoc.2022.101417. eCollection 2022 Jun.
Iris cysts may arise secondary to surgical or nonsurgical trauma, potentially leading to corneal decompensation via mechanical injury to the adjacent endothelium. However, no well-established protocol exists for the treatment for corneal edema arising therefrom.
A 58-year-old white male presented with an iris mass of his left eye; it occupied 1/3rd the anterior chamber volume and directly contacted the corneal endothelium. The cornea was diffusely edematous, and best corrected visual acuity (BCVA) measured 20/70 (0.3). Corneal endothelial decompensation secondary to iris cyst was diagnosed. Treatment consisted of endophotocoagulation and vitrectomy probe removal of the cyst wall, with Descemet membrane endothelial keratoplasty (DMEK) also performed as a single, combined procedure. The patient subsequently experienced a resolution of his corneal edema and disappearance of his iris cyst, without recurrence of either condition. BCVA improved to 20/25 (0.8).
Iris cyst may be a rare cause of corneal decompensation. Viable treatment may entail a single-stage procedure involving endophotocoagulation and vitrectomy probe application to the cyst wall combined with DMEK.
虹膜囊肿可能继发于手术或非手术创伤，有可能通过对相邻内皮细胞的机械损伤导致角膜失代偿。然而，对于由此引起的角膜水肿，目前尚无成熟的治疗方案。
一名58岁白人男性左眼出现虹膜肿物；该肿物占据前房容积的1/3，并直接接触角膜内皮。角膜弥漫性水肿，最佳矫正视力（BCVA）为20/70（0.3）。诊断为虹膜囊肿继发角膜内皮失代偿。治疗包括眼内光凝和用玻璃体切割探头去除囊肿壁，同时还作为单一联合手术进行了Descemet膜内皮角膜移植术（DMEK）。患者随后角膜水肿消退，虹膜囊肿消失，两种情况均未复发。BCVA提高到20/25（0.8）。
虹膜囊肿可能是角膜失代偿的罕见原因。可行的治疗可能需要采用单阶段手术，包括眼内光凝、用玻璃体切割探头处理囊肿壁并联合DMEK。
