Management of an iris stromal cyst by fine needle aspiration with absolute alcohol irrigation and argon laser photocoagulation to induce sclerosis

Purpose: To describe the management of an iris stromal cyst by fine needle aspiration and irrigation with absolute alcohol to induce cyst sclerosis.

Methods: We present the case of a 45-year-old patient with no previous history referred for a 3-month history of an iris lesion in his right eye. Examination revealed a 2.1×3mm cyst with transparent walls at the right inferonasal iris root, and a primary acquired iris stromal cyst was diagnosed. Initially, observation was recommended, but at the 2-month follow-up, growth of the lesion was observed, so fine needle aspiration and cryotherapy were performed, with recurrence after 2 months. Subsequently, fine needle aspiration and irrigation with absolute alcohol for 2minutes to induce sclerosis of the cyst was carried out. Two weeks after surgery, argon laser was performed on the iris root and remaining walls of the cyst to induce adherence.

Results: After 1 year of the procedure, the patient remains asymptomatic, without associated complications. A depression and hyperpigmentation of the iris in the inferonasal sector persists, without recurrence of internal fluid or increase in cyst volume. Endothelial cell count and intraocular pressure monitoring have remained stable.

Conclusion: Iris stromal cyst sclerosis by aspiration and irrigation with absolute alcohol was effective and avoided complications associated with resection of the lesion.