Late formation of iris cyst after penetrating keratoplasty

Purpose: The development of iris epithelial cysts is a rare complication following penetrating keratoplasty (PK). We present the natural history of two cases of large iris epithelial inclusion cysts that developed long after PK. Methods: We followed two patients who developed large iris epithelial cysts more than eight years following PK. The cysts were observed for 5.5 years (Case #1) and for 19 months (Case #2). Results: In case #1, the cyst enlarged and contacted the coraeal endothelnim, but did not compromise the graft. This cyst spontaneously involuted 4.5 years after onset. Ih case #2, the cyst has slowly enlarged and is currently being monitored closely. Conclusions: These cases illustrate the late development of iris epithelial cysts as a rare complication of PK. The natural history of these two cases suggests that initial observation of these lesions may be the most reasonable approach.