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Argon Laser Photocystotomy of a Vitreous Cyst.

Free-floating idiopathic vitreous cysts are rare entities. For symptomatic patients, treatment options include laser photocystotomy or pars plana vitrectomy (PPV) with cyst excision. Historically, size of the cyst impacted treatment approaches. Laser treatments have been used for smaller cysts ranging 3 to 5 mm in diameter. PPV has been utilized for cysts larger than 4 mm. Successful laser photocystotomy has been reported, utilizing both argon and Nd: YAG lasers. Herein, we present a case of successful argon laser photocystotomy of a 7.1 mm diameter vitreous cyst, the largest documented cyst ever treated. Treatment should be individualized based on patient age, ability to cooperate in an office setting, phakic status, status of the posterior hyaloid, cyst morphology, and location. In our case, because of pigment on the anterior cyst surface, and the presence of an attached posterior hyaloid, the argon green laser was used.