Lens absorption secondary to uveitis

A 24-year-old woman with a 10-year history of recurrent uveitis presented with progressive visual loss in the left eye due to cataract formation, with corrected distance visual acuity (CDVA) of hand motion. Ultrasound biomicroscopy (UBM) revealed a thinned lens with extensive synechiae between the iris and the anterior lens capsule (Figure 1, A). Intraoperatively, a dense pigment membrane was found adherent to the anterior lens surface, and the lens appeared white and absorbed (Figure 1, B). After synechiolysis and capsulorhexis, a small amount of lens cortex was removed and fibrotic posterior capsule was noted; a posterior capsulotomy was performed before intraocular lens implantation (Figure 1, C and D). One week postoperatively, CDVA improved to 20/32. Lens absorption has been reported in hypermature and traumatic cataracts, as well as in uveitic or infectious ocular disease.1,2 To the authors' knowledge, this is the first report to document such a case using both UBM and intraoperative photographs.Figure 1.: A: Ultrasound biomicroscopy of the left eye showing posterior synechiae, pupillary membrane (green arrows), lens thinning, and extensive cortical resorption, with only a small amount of residual cortex remaining. B: Mydriatic photograph of the left eye demonstrating adhesion between the iris and the anterior lens surface (red arrow), along with pigment membrane attachment on the lens surface (blue arrow). C: After staining the anterior capsule with indocyanine green, continuous curvilinear capsulorhexis (black arrow) and removal of residual cortical material were performed, revealing a densely fibrotic and opaque posterior capsule (yellow arrow). D: After creation of a central opening in the thickened and fibrotic posterior capsule using capsular scissors, an intraocular lens was implanted into the capsular bag. Opacities in the anterior vitreous are also visible (purple arrow).