Background: Iris cyst can lead to iridocyclitis, angle closure, secondary glaucoma, corneal decompensation, band keratopathy, cataract, subluxation of the lens, or visual disturbance leading to amblyopia or strabismus. Incomplete removal of cyst can lead to recurrence. Recurrent surgeries are more complicated and compromise prognosis. So, complete removal of cyst with minimal anatomical disturbances is essential for better outcomes.
Purpose: To define a new technique of triple treatment therapy for iris cyst management.
Synopsis: Iris cyst was treated in three steps. In the first step, iris cyst aspiration followed by cyst cavity treatment with mitomycin-C was done. After that, cyst cavity was irrigated with balanced salt solution (BSS). In the second step, the anterior cyst wall was removed with a vitrectomy cutter. In the third step, the posterior cyst wall was cauterized with diathermy.
Highlights: In this technique, we chose a minimally invasive approach utilizing two 1-mm incisions leading to less astigmatism. Iridectomy was not performed, which led to a small iris defect postoperatively, and pupilloplasty was not required. Injection of mitomycin-C led to destruction of the cyst wall, and diathermy further reduced the chance of recurrence by destroying the cyst base. Postoperatively, mild corneal edema was noted, which resolved in 1 week. Topical steroids were given to control postoperative inflammation. No recurrence has been noted till 6 months of follow-up. The more conservative approach seemed to result in better visual outcomes.
Discussion: Wide varieties of approaches are available for iris cysts, like laser cystotomy, aspiration, diathermy, cryotherapy, injection of sclerosing agents, and surgery.[1] Yu et al.[2] treated iris cyst in a 60-year-old female with cyst content aspiration using 30G needle, followed by injection of 0.0002 mg/ml mitomycin-C in the cavity for 5 min. BSS wash was given five times at the end. They noted a decrease of 13.3% in endothelial cell count following the procedure. They speculate that transient application of MMC can cause permanent damage to the epithelial and goblet cells that secrete cyst fluid, hence resulting in regression of the cyst. Similarly, Kawaguchi et al.[3] aspirated cyst fluid with a 30G needle and left 0.3 ml of 10-3 mg/ml mitomycin-C for 5 min in the cavity, followed by BSS wash in a 32-year-old female with recurrent iris cyst. They reported a decrease of 4% in endothelial cell count postprocedure. Shen et al.[4] used micro diathermy to treat residual cyst wall attached to the endothelium and base of cyst in four cases. In our case, we have combined cyst aspiration, mitomycin-C, excision using vitrectomy cutter, and diathermy. No recurrence has been observed at the longest follow-up of 3 years. However, a small sample size and less duration of follow-up are the limitations to call it the best approach.
Video Link: https://youtu.be/EC6WA2TiaAE.
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http://dx.doi.org/10.4103/IJO.IJO_2897_23 | DOI Listing |
Lancet Digit Health
December 2024
Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address:
Microbiology reference laboratories perform a crucial role within public health systems. This role was especially evident during the COVID-19 pandemic. In this Viewpoint, we emphasise the importance of microbiology reference laboratories and highlight the types of digital data and expertise they provide, which benefit national and international public health.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Aspergillus-related immune reconstitution inflammatory syndrome (IRIS) is a challenge to diagnose in immunocompromised pediatric cancer patients with Invasive Pulmonary Aspergillosis (IPA). If not recognized, it can mimic disease progression and lead to overtreatment. Studies on Aspergillus-related IRIS in the pediatric population are scarce.
View Article and Find Full Text PDFEur Radiol
December 2024
Department of Radiology AZ Sint Maarten Mechelen, University (Hospital) Antwerp, Antwerp, Belgium.
Objectives: An update of the first European Society of Musculoskeletal Radiology (ESSR) consensus on soft tissue tumor imaging in 2015 became necessary due to technical advancements, further insights into specific entities, and the revised WHO classification (2020) and AJCC staging system (2017). The third part of the revised guidelines covers algorithms and techniques beyond initial imaging: (1) Imaging after neoadjuvant therapy in soft tissue sarcoma, (2) sarcoma surveillance, and (3) special aspects, including surveillance of non-malignant entities and the role of interventional radiology.
Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.
Cureus
November 2024
Advanced Prosthodontics, Institute of Science Tokyo, Tokyo, JPN.
Orbital defects can result from a myriad of underlying diseases and injuries. Treatment of malignant neoplasms and maxillofacial trauma are common reasons for orbital exenteration. Recently, a growing number of cases of orbital defects have been reported due to mucormycosis in patients with COVID-19.
View Article and Find Full Text PDFClin Lung Cancer
November 2024
Department of Radiation Oncology, Tenon University Hospital, APHP, Sorbonne University, Paris, France; Laboratoire d'Imagerie Biomédicale UMR 7371 - U1146, Sorbonne University, Paris, France.
Background: Treatment of locally advanced non small cell lung cancer (LA-NSCLC) is based on (chemo)radiotherapy, which may cause acute lung toxicity: radiation pneumonitis (RP). Its frequency seems to increase by the use of adjuvant durvalumab therapy.
Aims: To identify clinical, dosimetric, and radiomic factors associated with grade (G)≥2 RP and build a prediction model based on selected parameters.
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