Epilens membrane simulating cataract in children with uveitis: a report of three cases

Abstract

Here we present the cases of three female children, of whom two were aged 6 years and one was aged 11 years. Two of the three children had bilateral uveitis and suspected cataract and Vogt-Koyanagi-Harada (VKH) disease. The third one had uveitis and suspected cataract in one eye and sympathetic ophthalmia (SO), and had undergone penetrating keratoplasty in the fellow eye following a trauma. After controlling the inflammation, we planned to perform phacoemulsification without intraocular lens implantation. However, intraoperatively, after removing the epilens membranes, the lenses appeared clear, and therefore phacoemulsification was not performed. During follow-up, the patients did not develop cataract, and visual acuity levels ranged from 20/30 to 20/100. Fundoscopy revealed VKH disease and SO. Ophthalmologists should not always assume that patients with uveitis have cataract; a transparent lens may exist behind the epilens membrane, allowing a less aggressive therapeutic approach.

Ultrasound biomicroscopy in the management of complex cataract and intraocular lens: A review

“…Epilens membrane may simulate cataract in paediatric uveitic eyes despite a clear lens 33 . Preoperative UBM can assess for the presence of any cataract, 34 and the surgeon should take care to avoid anterior capsule breach during the release of the pupillary membrane and synechiolysis if the lens is clear.…”

Preoperative usage of ultrasound biomicroscopy in pediatric cataract

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Uso pré-operatório de biomicroscopia ultrassônica em catarata pediátricaDear Editor: I read the article "Epilens membrane simulating cataract in children with uveitis: a report of three cases" by Paiva et al with great interest (1) . Three cases were presented that were diagnosed as cataract secondary to uveitis but that were understood to have received treatment for pupillary membrane intraoperatively.

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