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Impressum
Cataracta membranacea - an unusual case report
Walter S., Heuring A. H., Menkhaus S., Behrens-Baumann W.
Otto-von-Guericke-University Magdeburg, Department of Ophthalmology, Leipziger St. 44; D-39120 Magdeburg, Germany
Introduction: The first cataracta membranacea was described by
v. Ammon in 1833. This seldom cataract is characterized by degenerated
lens zonula fibers, which becomes liquefied until a thin layer of anterior
and posterior lens capsula fibers remains. Proliferation of rudimental
lens zonula and epithelial cells progresses and finally forms a complete
opaque lens usually already at time of birth.
Patient: A 27 year old patient was referred to our hospital because
of slowly progressive visual acuity loss. In his childhood he had good
visual acuity in both eyes. In 1997 his right eye was treated with a Nd:YAG
laser capsulotomy.
Clinical findings: Biomicroscopy revealed a opaque membrane behind
the pupillary area, which looked like a capsula fibrosis after cataract
surgery. Ultrasound biomicroscopy demonstrated at the right eye in the
equator region a thinning of the membrane only in the axial axis. The
periphery was almost normally round shaped configured. On the left eye
an almost complete membranous structure -also in the equator region- was
detected. On both eyes a capsulotomy, cutting of the membrane with vitreoretinale
scissor and anterior vitrectomy was performed. In addition a sulcus fixed
PMMA-intraocular lens (7mm optic and 13,5mm diameter) was implanted in
both eyes (+22,0 dpt and +20,0 dpt respectively). The two month follow
up revealed a centric, sulcus fixed intraocular lens for both eyes. Visual
acuity for OD was 0,9 and for OS 1,0p.
Discussion: In this case a satisfying postoperative visual acuity
was achieved. This unusual case was unique due to different lens shapes.
We can only speculate, that cases of cataracta membranacea are possibly
the developed form of cataracta annulare. But, since this is an extreme
seldom disease, it will be very hard to proof.