Acute emergence of a post-phacoemulsification inflammatory membrane: Ophthalmological enigma revealed

Abstract

Purpose: This case reports the manifestation of a postoperative inflammatory membrane in a 75-year-old patient with a grade 3 corticonuclear cataract and pseudoexfoliations. The aim of this study is to discuss complications associated with pseudoexfoliations during cataract surgery and therapeutic approaches. Case report: The patient, a type 2 diabetic, presented with a bilateral decrease in visual acuity. Ophthalmological examination revealed pseudoexfoliations impeding pupillary dilation. After phacoemulsification with iris retractors, a postoperative inflammatory membrane developed in the right eye, leading to corneal edema, elevated intraocular pressure and reduced visual acuity. Discussion: Pseudoexfoliations complicate cataract surgery by limiting pupillary dilation, increasing the risk of complications such as capsular rupture or zonulopathy. The inflammatory membrane, which differs from cyclitic inflammations, probably results from an abnormal immune response to pseudoexfoliative material. Corticosteroids are used for their anti-inflammatory and anti-fibrotic effect, and surgery may be required in cases of resistance to treatment. Conclusion: Postoperative inflammatory membrane in patients with pseudoexfoliations during cataract surgery represents a serious complication requiring prompt recognition and appropriate corticosteroid treatment, underlining the crucial importance of early management to improve visual prognosis and reduce long-term complications.