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Impressum
Complications of a voluminous cyst of the ciliary body
Kottler U., Schwenn O., Pfeiffer N.
Augenklinik und Poliklinik der Johannes Gutenberg-Universität Mainz
Multiple cysts of the iris and the ciliary body may cause many complications
such as acute or chronic angle closure glaucoma. We present the case of
a young boy with multiple congenital cysts of the iris pigment epithelium
and a voluminous cyst of the unpigmented epithelium of the ciliary body
of the right eye. First of all it caused a lenticular astigmatism and
concomitant strabismus divergens of the right eye and in progress an anisometropia
was developed. Already at the first presentation at the age of 4 months
a bulging of the iris from ½ 7 until 12 o'clock with contact of
iris and corneal endothelium was evident. The voluminous cyst (8x12mm
in diameter) was folded like a dumb-bell around the lens, reached the
optic axis and caused a displacement of the lens. In addition, there were
little cysts of the iris pigment epithelium near the pupillary edge. A
strabismus divergens (-8°) of the right eye was noted, the refraction
in cycloplegia was +0,50/-2,0/110° right and +2,0/-0,5/30° left.
Via the pars plana and a paracentesis the cyst was cut off partially and
liquid equal to the aqueous humor was acquired. A covering treatment of
the left eye and the application of mydriatics to the right eye as a precaution
against amblyopia was begun. In the sequel the boy developed subcapsular
multivesicular cataractous clouding of the temporal half of the lens and
a progredient myopia of the right eye (up to - 14,0/-2,0/0°) meanwhile
the left eye was hyperopic (+3,5/-3,75/0°). The lens was subluxated
nasally and superior due to damage of the zonular fibers in the affected
region. Proceeding on the assumption that the development of the visual
acuity was limited by these determinants (0,1 at the right eye), cataract
surgery with a posterior capsulorhexis and with implantation of a capsular
tension ring and a posterior chamber intraocular lens was performed at
the age of four. At the last examination the visual acuity was up to 0,6
in the right and 1,25 in the left eye (Lea Hyvärinen-test). There
is actually an orthotropia; the existance of stereoscopic vision is supposed.