EPITHELIAL INCLUSION CYST OF THE IRIS

We describe the clinical presentation, high-frequency ultrasound biomi croscopic characteristics, and pathologic findings associated with a c onjunctival inclusion Cyst within the iris. The patient had undergone an uncomplicated extracapsular cataract extraction with posterior cham ber intraocular lens insertion 9 months prior to presenting with a pro gressively enlarging iris mass. A clinical examination revealed a soli d-appearing white tumor within the midiris stroma, accompanied by limb al-conjunctival hyperemia and anterior chamber inflammation. Ultrasoun d biomicroscopy revealed an egg-shaped solid iris stromal tumor that d isplaced the pigment epithelium. The mass was composed of three concen tric layers of different echogenicity: a moderately reflective mantle, a less reflective middle zone, and a hyperreflective core. Within 3 d ays of initiation of topical corticosteroid therapy (prednisolone acet ate, 0.5 mg per drop four times daily), the tumor enlarged and induced a plasmoid aqueous and a hypopyon. Histopathologic study revealed a c onjunctival inclusion cyst with evidence of acute and chronic inflamma tion. We have found that the diagnosis of epithelial inclusion cyst wi thin the iris can be aided by an ultrasound evaluation. This case also suggests that it may be preferable to excise these tumors prior to to pical corticosteroid treatment.