A Multifaceted Presentation of the Retrocorneal Membrane Following Intraocular Surgery: A Case Series

The retrocorneal membrane is a rare but serious complication of intraocular surgery, presenting in varied forms. This case series highlights three patients who developed retrocorneal membranes following different ocular procedures. The first case involves a 67-year-old man with a history of right open globe rupture. He underwent multiple surgeries and developed corneal decompensation, for which Descemet stripping automated endothelial keratoplasty (DSAEK) was performed. He later developed a recurrent epithelial downgrowth (EDG) membrane. The second case presents a 79-year-old man who presented with a worsening vision to 3/60, one year after a complicated cataract surgery, due to a temporally growing fibrous downgrowth. The third describes a 70-year-old man who experienced blurred vision with visual acuity (VA) of 6/60, caused by a nasally growing fibrous downgrowth 10 months post-endothelial keratoplasty. All patients underwent retrocorneal membrane peeling combined with intracameral 5-fluorouracil (5-FU) treatment. This report discusses their clinical presentations, ocular imaging, treatment approaches, and histopathological findings. Retrocorneal membranes, particularly EDG, are difficult to manage and often result in poor visual outcomes despite treatment. While histopathology (HPE) remains the gold standard for diagnosis, clinical evaluation, anterior segment optical coherence tomography (AS-OCT), and regular follow-up are essential in guiding management. Further research is needed to improve the understanding and treatment of this rare condition.