Supplementary Material for: Surgical Cystotomy of a Large Iris Pigment Epithelial Cyst with Microinstrumentation

<b><i>Purpose:</i></b> Surgical intervention is indicated for large primary iris pigment epithelial cysts that significantly affect vision or compromise adjacent structures. Methods described in the literature include laser photocoagulation, needle aspiration, and complete resection. <b><i>Methods:</i></b> We describe a novel surgical technique in which a surgical cystotomy is created for a large, symptomatic iris pigment epithelial cyst using microsurgical instruments for a patient in whom needle aspiration was unsuccessful. <b><i>Results:</i></b> The patient’s visual symptoms had largely resolved within 1 week postoperatively, no complications were encountered, and there was no clinical or sonographic evidence of cyst recurrence after 14 months. <b><i>Conclusion:</i></b> Surgical cystotomy with microinstrumentation may be an effective tool for management of primary iris pigment epithelial cysts, especially as an alternative after needle aspiration fails

Epithelial breakthrough during IntraLase flap creation for laser in situ keratomileusis.

We report the clinical manifestations and outcomes in 4 patients who experienced premature gas-bubble leakage during raster lamellar dissection during IntraLase femtosecond laser corneal flap creation. Three patients experienced a full-thickness epithelial breakthrough and the fourth, a flap tear. The patient who experienced the flap tear was unable to have laser in situ keratomileusis successfully. The flap complications did not result in a decreased best corrected visual acuity in any patient but may have resulted in epithelial ingrowth in one and a corneal scar and microstriae in another. Potential predisposing factors for epithelial breakthrough, the incidence of epithelial breakthrough, and methods for avoiding and salvaging traumatic corneal flaps are discussed