Posterior lens capsule neovascularization treated with anti-VEGF complicated by phacogenic uveitis

Felicia Tai; Efrem D Mandelcorn; Sohel Somani

doi:10.1016/j.ajoc.2020.100943

Posterior lens capsule neovascularization treated with anti-VEGF complicated by phacogenic uveitis

Am J Ophthalmol Case Rep. 2020 Oct 3:20:100943. doi: 10.1016/j.ajoc.2020.100943. eCollection 2020 Dec.

Authors

Felicia Tai¹, Efrem D Mandelcorn^{2

3

4}, Sohel Somani^{2

3

5}

Affiliations

¹ Faculty of Medicine, University of Toronto, Canada.
² Department of Ophthalmology & Vision Sciences, University of Toronto, Canada.
³ Uptown Eye Specialists, Concord, Ontario, Canada.
⁴ Toronto Western Hospital, Toronto, Ontario, Canada.
⁵ William Osler Health Centre, Brampton, Ontario, Canada.

Abstract

Purpose: To report a case of neovascularization of posterior capsule (NVPC) successfully treated with intravitreal ranibizumab (Lucentis) and neodymium:YAG (Nd:YAG) capsulotomy, followed by phacogenic uveitis.

Observations: We report a systemically otherwise healthy 81-year-old male presenting with unilateral NVPC and iris (NVI) occurring five years after a central retinal vein occlusion. A single intravitreal injection of ranibizumab led to complete regression of NVPC and NVI within three weeks after which a Nd:YAG capsulotomy was performed. Two weeks later, the patient returned with a severe inflammatory reaction diagnosed as phacogenic uveitis and treated with surgical capsular bag/intraocular lens complex removal and peripheral pan-retinal photocoagulation. One-year follow-up demonstrated no recurrence of NVPC. Visual acuity remained at baseline of light perception.

Conclusions: We acknowledge that intravitreal anti-vascular endothelial growth factor treatment with Nd:YAG capsulotomy for NVPC is a rational option, but raise awareness to the rare possibility of phacogenic uveitis.

Keywords: Central retinal vein occlusion; Lens-induced uveitis; Neovascularization; Neovascularization of posterior capsule; Phacogenic uveitis.

Publication types

Case Reports