UNILATERAL SPONTANEOUS RESORPTION OF THE LENS

Published 2025 - 29th ESCRS Winter Meeting

Reference: PO084 | Type: Presented Poster & Poster | DOI: 10.82333/t0j3-q860

Authors: Cristina Rastoaca* ¹ , Tobias Kiefer ¹ , Eva Biewald ¹ , Nikolaos E. Bechrakis ¹

¹Ophthalmology,Universitätsmedizin Essen,Essen,Germany

Purpose

To report a case of spontaneous absorption of a pediatric cataract in a 3-year-old child diagnosed with unilateral persistent fetal vasculature.

Setting

The spontaneous absorption of a natural crystalline lens is an exceptionally rare occurrence. It can happen spontaneously or as a secondary result of ocular trauma. Additionally, it may be associated with various conditions, including systemic infections, uveitis, persistent fetal vasculature (PFV), Hallermann-Streiff-Francois syndrome, Down syndrome, and Morgagnian cataracts, among others. The debate regarding the underlying mechanism of absorption in cases with no identifiable cause, such as the one presented here, remains ongoing. However, what makes this case unique is the complete absorption of the lens material, while the capsular bag remained remarkably intact.

Methods

Following the initial suspicion of unilateral retinoblastoma, we conducted routine evaluations, including ocular sonography, ultrasound biomicroscopy (UBM), and photographic documentation under general anesthesia, followed by MRI scans for further diagnostic assessment in this child.

Results

Over a 6-month period, MRI scans revealed a complete resorption of the lens, while clinically, a retroiridal, vascularized membrane was visible, with no further view of the fundus. Both sonography and MRI ruled out any intraocular mass. We decided to proceed with a membraneectomy, along with lensectomy to remove the residual lens material, and an exploratory vitrectomy. Intraoperatively, we discovered an intact capsular bag, enabling us to implant a standard posterior chamber lens. The membrane and residual lens material were sent for histopathological analysis, which ruled out the presence of a tumor.

Conclusion

Cataract absorption is very uncommon in humans, yet it has been documented in the literature since 1835. The transport of lens material across the capsule is likely facilitated by one of four mechanisms: leakage (both gross and microscopic), diffusion, active transport, or endo- or exocytosis. To better understand these mechanisms, further studies are essential.