Pseudo second anterior lens capsule during post-vitrectomy cataract surgery: A case report
Laura E Drew-Bear1, Mya Abousy1, Charles G Eberhart1
1The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
American Journal of Ophthalmology Case Reports
|September 16, 2022
Summary
During cataract surgery, a membrane mimicking a second anterior lens capsule was unexpectedly found after pars plana vitrectomy and silicone oil use for retinal detachment. This fibrocellular tissue may inform surgeons about rare intraoperative findings.
Area of Science:
- Ophthalmology
- Surgical Pathology
Background:
- Pars plana vitrectomy (PPV) with silicone oil tamponade is a common treatment for retinal detachment.
- Complications can arise, necessitating further surgical intervention such as cataract extraction.
Observation:
- A 26-year-old male with prior PPV and silicone oil for retinal detachment developed a cataract and anterior chamber silicone oil migration.
- During combined cataract extraction and silicone oil removal, a membrane obstructing capsulorrhexis was identified.
Findings:
- The unexpected membrane behaved as a second anterior lens capsule during the capsulorrhexis procedure.
- Pathological examination revealed fibrocellular tissue expressing PAX8 and cytokeratin AE1/AE3.
Implications:
- This case highlights a rare intraoperative finding during cataract surgery in patients with a history of PPV and silicone oil.
- Understanding this pathology can improve surgical preparedness and management of similar unexpected findings during capsulorrhexis.
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