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.
This present study shows, that modern cataract surgery makes it possible to achieve good operative results, even in risk patients. Preoperative presence of PEX had no influence on the complication rate of cataract surgery.
About 12-13% of people with impaired vision have visual hallucinations. Neurologic and psychiatric diseases should be excluded before making a diagnosis of CBS which has little impact on the general feelings of well-being in the majority of patients. Many patients do not consult a doctor about CBS for fear of being considered insane. It is recommended that all patients with reduced vision are asked about visual hallucinations. Many patients will benefit from an explanation of these phenomena and the assurance of their harmless nature. Treatment of CBS is rarely needed.
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