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Diagnosis and management of post - traumatic pearl iris cyst

Epithelial iris cysts still comprise a mystery with regard to pathogenesis, modes of presentation, and response to treatment. Here, we report an 8-year-old boy who presented with a pearly white iris cyst, 2-year postcorneal tear repair. After Anterior segment optical coherence tomography confirmation, an en block resection of the cyst was done. Eleven months later the patient presented with recurrence of the iris cyst. This recurrence was due to incomplete removal of the epithelial tissue lining the pearly cyst. Ultrasound bio-microscopy (UBM) was done to delineated the posterior extent of the cyst, and a sector iridectomy with a 4 mm margin around the cyst was done. Our case reinforces the fact that delineating the extent of these iris cysts posteriorly with UBM is mandatory in all cases, and it provides a basis for surgical resection for favorable visual outcomes.