Modified Three-port Approach for Absolute Alcohol-induced Sclerosis of Iris Stromal Cyst: A Case Report.
- 1Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
- 2Eye Institute, St. Luke's Medical Center, Quezon City, Philippines.
Abstract
Iris stromal cysts are rare, progressive ocular lesions that can cause visual impairment and amblyopia due to visual axis obstruction, corneal endothelial damage, uveitis, and secondary angle-closure glaucoma. Management is challenging due to recurrence, and surgical resection carries severe risks such as epithelial downgrowth, glaucoma, blindness, and potential loss of the eye. Absolute alcohol-induced sclerosis is a less invasive alternative; however, the literature on technique modifications remains limited. This case report describes the successful management of a primary iris stromal cyst with secondary ocular hypertension in a 9-year-old Filipino male using a modified three-port approach for absolute alcohol-induced sclerosis. The patient presented with a 4-month history of intermittent redness and pain in the left eye and was found to have elevated intraocular pressure (IOP) due to an iris stromal cyst. A modified three-port setup was prepared using a 30-gauge needle connected to a 3-way stopcock, a 3-mL syringe for aspiration, and an extension tube connected to a syringe containing absolute alcohol mixed with trypan blue dye. Although a 3-mL syringe was used for alcohol infusion, a 1-mL syringe may provide finer control. Postoperatively, transient corneal edema, mild anterior chamber inflammation, and steroid-induced intraocular pressure elevation were observed but resolved with medical management. At 18 months post-surgery, the patient remained asymptomatic, with a best-corrected visual acuity of 20/20, well-controlled IOP without medication, and no cyst recurrence. This case illustrates the effectiveness of a modified three-port approach in treating iris stromal cysts while preventing complications such as visual axis obstruction, glaucoma, and the need for more invasive surgery. This technique presents a practical and accessible option, especially in resource-limited settings. The paper also emphasizes the importance of meticulous technique and awareness of alcohol leakage, with key precautions outlined for safe application.
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BibTeX
@article{santos2026modified,
title = {{Modified Three-port Approach for Absolute Alcohol-induced Sclerosis of Iris Stromal Cyst: A Case Report.}},
author = {Bobbie Marie M Santos and Jayvee S Rivera and George Michael N Sosuan and Reginald Robert G Tan and Ruben Lim Bon Siong},
journal = {Acta medica Philippina},
year = {2026},
month = sep,
doi = {10.47895/amp.v60i17.13492},
url = {https://europepmc.org/article/MED/42952907},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Modified Three-port Approach for Absolute Alcohol-induced Sclerosis of Iris Stromal Cyst: A Case Report.
AU - Bobbie Marie M Santos
AU - Jayvee S Rivera
AU - George Michael N Sosuan
AU - Reginald Robert G Tan
AU - Ruben Lim Bon Siong
PY - 2026
DA - 2026/09/15
JO - Acta medica Philippina
DO - 10.47895/amp.v60i17.13492
UR - https://europepmc.org/article/MED/42952907
AB - Iris stromal cysts are rare, progressive ocular lesions that can cause visual impairment and amblyopia due to visual axis obstruction, corneal endothelial damage, uveitis, and secondary angle-closure glaucoma. Management is challenging due to recurrence, and surgical resection carries severe risks such as epithelial downgrowth, glaucoma, blindness, and potential loss of the eye. Absolute alcohol-induced sclerosis is a less invasive alternative; however, the literature on technique modifications remains limited. This case report describes the successful management of a primary iris stromal cyst with secondary ocular hypertension in a 9-year-old Filipino male using a modified three-port approach for absolute alcohol-induced sclerosis. The patient presented with a 4-month history of intermittent redness and pain in the left eye and was found to have elevated intraocular pressure (IOP) due to an iris stromal cyst. A modified three-port setup was prepared using a 30-gauge needle connected to a 3-way stopcock, a 3-mL syringe for aspiration, and an extension tube connected to a syringe containing absolute alcohol mixed with trypan blue dye. Although a 3-mL syringe was used for alcohol infusion, a 1-mL syringe may provide finer control. Postoperatively, transient corneal edema, mild anterior chamber inflammation, and steroid-induced intraocular pressure elevation were observed but resolved with medical management. At 18 months post-surgery, the patient remained asymptomatic, with a best-corrected visual acuity of 20/20, well-controlled IOP without medication, and no cyst recurrence. This case illustrates the effectiveness of a modified three-port approach in treating iris stromal cysts while preventing complications such as visual axis obstruction, glaucoma, and the need for more invasive surgery. This technique presents a practical and accessible option, especially in resource-limited settings. The paper also emphasizes the importance of meticulous technique and awareness of alcohol leakage, with key precautions outlined for safe application.
SN - 0001-6071
SN - 2094-9278
ER -