|Year : 1982 | Volume
| Issue : 2 | Page : 115-116
Traumatic implantation cyst of iris
US Srivastava, R Gogi, R Maheshwari
Gandhi Eye Hospital and AMU Institute of Ophthalmology, Aligarh, India
U S Srivastava
Gandhi Eye Hospital and AMU Institute of Ophthalmology, Aligarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Srivastava U S, Gogi R, Maheshwari R. Traumatic implantation cyst of iris. Indian J Ophthalmol 1982;30:115-6
Traumatic iris cyst is a rare clinical entity. These cysts can either be solid looking mass lined by stratified or cubical epithelium (pearl cyst), or serous type of cyst containing straw coloured turbid fluid. It looks transparent on examination and is lined by stretched out thin and atrophic flattened epithelium. Former type of cysts are comparatively rare. The present case is reported because of its rarity and clinical curiosity.
| Case report|| |
A female 32 years old child was brought with the history of gradual painful loss of vision following perforating injury with pointed iron nail in right eye about two months back. On examination there was ciliary congestion, deep corneal opacities; anterior chamber, pupil, leas and fundus could not be visualized. Vision was limited to hand movements. Intra ocular pressure was 42 m.m. of Hg. Sch. To relieve the intraocular pressure and pain Scheie's filtering operation was done, however it did not help much and her eye had to be enucleated after four weeks and was subjected for pathological examination.
On gross examination the eye ball measured 24 x 23 x 24 m.m. The microscopic examination revealed normal corneal epithelium but irregular thickening of the Bowman's membrane. There was superficial and midstromal corneal vascularizatlon and the deeper part of the stroma was infiltrated by polymorphonuclear leucocytes and Lymphocytes. There was a healed track of Corneal Perforation lined by stratified squamous epithelium. The posterior surface of the cornea was also lined by stratified epithelium [Figure - 1]a, which was continuous towards the periphery and was lining the angle of anterior chamber and anterior surface of the iris [Figure l]b. At places the same epithelium was invaginating into the iris tissue to form a cyst, The cyst was lined by stratified squamous epithelium and there was fibrinous material in its lumen [Figure - 2][Figure - 3]. There was no evidence of epithelial degeneration. Uveal tissue was atrophic. Lens was cataractous with the evidence of posterior synechia.
Retina was detached and disorganised. The optic nerve head showed evidence of glaucomatous cupping.
| Discussion|| |
Two types of traumatic Implantation cysts of iris have been described in the literature, depending upon their gross examination; the histological picture of the two also differs: the first is named as Pearl cyst which is a solid looking cyst lined by stratified squamous epithelium having concentric lamellar layers and clear cystic space in the centre. While the other is known as serous cyst. It has a thin wall and is lined by stretched out and flattened atrophic epithelium. It looks transparent on clinical examination. The iris cyst reported here although lined by stratified squamous epithelium yet it does not fit exactly into the diagnosis of Pearl cyst, because the cyst did not reveal any lamellar pattern and there was no evidence of epithelial degeneration. Therefore the genesis of the so-called pearl cyst appears to be different then what is described in literature. We feel that the invaginated stratified squamous epithelium first of all lines the crypts of the iris. The anterior surface of the crypts is bridged by exudates from intermittent uveal inflammation. The inner surface of these bridge ultimately lined by stratified squamous epithelium, thus completing the typical microscopic picture.
| Summary|| |
A case of traumatic implantation cyst of iris following perforating injury with pointed iron nail has been reported. The probable genesis of the cyst has also been discussed.
| References|| |
Duke Elders, 1972, "System of Opthalmology" Vol. XIV Pt. I P. 415-418 Henry Kimpton' London.
[Figure - 1], [Figure - 2], [Figure - 3]