A 27-year-old man with no history of intraocular surgery presented with progressive blurred vision in both eyes. Slitlamp evaluation revealed a white, thin membrane in the pupillary area that resembled posterior capsule opacification. A naturally formed lens was absent. Ultrasound biomicroscopy demonstrated a rarefaction of lens fibers in the equator region with a loss of the normal anatomic lens structure on the left side. Visual acuity was 20/32 with +10.00 -0.75 x 170 in the right eye and 20/100 with +11.50 -0.50 x 25 in the left eye. After capsulotomy and excision of the membranous capsule, an anterior vitrectomy, and implantation of a sulcus-fixed intraocular lens in both eyes, the patient was highly satisfied with the final visual outcome. The patient had stereopsis, which supported his history of good visual function in childhood.
Inverted papilloma of the conjunctiva is an unusual diagnosis and to date there is no previous report of malignant transformation. With only seven cases described so far the biologic behavior remains uncertain, but it seems to be more aggressive than assumed so far. Complete excision is the treatment of choice, but patients should be carefully observed and adjuvant therapy could be necessary to ensure tumour control.
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