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Surgeons need to be aware that iStent placement may be complicated by severe endophthalmitis. To describe imaging findings and encourage the use of distilled water as an adjuvant osmolytic in the surgical management of corneal intrastromal cysts. A five-year-old female with no history of ocular trauma presented with a visually significant corneal opacity of the left eye. She was diagnosed with a presumed corneal intrastromal cyst and underwent surgical excision with distilled water osmolysis of the cyst cavity. Optical coher