Surgical Management versus Spontaneous Resorption of Congenital Membranous Cataracts

Purpose : To report a rare case of spontaneous resorption of a membranous congenital cataract in an adult woman with no systemic disease, with complete absorption of the central lens material, anterior and posterior capsules of the right eye, and partial absorption of the lens material with intact anterior capsule in the left eye.Case report : A 23-year-old woman was referred to our clinic suffering from decreased vision from childhood. Her visual acuity (VA) was 1/10 in the right eye (OD) and FC (40 cm) in the left eye (OS) after correction with +10.25 spherical Diopter in both eyes (OU). Her ocular history revealed profound low vision and nystagmus from childhood, with no prior intervention in either eye. The slit examination of the right eye revealed white opaque membranes at the periphery of the lens which were presumably remnants of the lens capsule. The central lens material was completely absorbed as well as anterior and posterior capsules, mimicking a surgical anterior and posterior capsulorrhexis. The left eye examination showed membranous cataract presenting as a piece of dense white fibrotic membrane and small amount of residual cortex at the peripheral part. The chalky-white lens material was partially absorbed with intact anterior capsule.Conclusion : As complete spontaneous resorption of membraneous congenital cataracts leading to high refractive hyperopia and amblyopia may happen in children with congenital cataracts, careful ocular examinations seems to be essential to avoid neglecting comorbid pathologies specially in children with high refractive errors and/or amblyopia. Surgical management of membranous cataracts need special considerations