We report a novel three-step technique that incorporates microscope-integrated optical coherence tomography (mi-OCT) guidance, controlled cyst aspiration, fibrin glue instillation, and en bloc excision. This approach was applied in two pediatric patients, a six-month-old female and a three-month-old male, with primary iris cysts obscuring the visual axis. Both patients underwent cyst excision with no intraoperative complications. Visual axis clarity was restored, and no recurrence was noted at 2 and a half years a…