A Pediatric Case Of Post-Traumatic Spontaneous Lens Absorption

To report a case of spontaneous lens absorption after penetrating trauma in a pediatric patient.

Spontaneous absorption of crystalline lens is a very rare condition associated with different ocular pathology including infectious or uveitic disorders, hypermature or traumatic cataract but also with systemic disorders. The exact pathophysiology is poorly understood and could vary according to the cause. In our knowledge, this is the first reported case of spontaneous lens absorption after penetrating trauma in a pediatric patient.

12 years old Somalian refugee presents in our clinic with a diminution of vision since a penetrating traumatism in her right eye 2 years before. Slit lamp examination shows a corneal scar of penetrating injury, an open anterior capsule with fibrosis and an intact posterior capsule. Fundus examination and macular OCT showed an intact optic nerve head and a normal macula. Anterior segment OCT and ultrasonography reveal complete absence of lens material and an open and fibrotic anterior capsule with preserved posterior capsule. Uncorrected visual acuity was limited to counting fingers in the right eye. Intraoperative exploration confirms a physiological posterior capsule. Anterior rhexis has been completed and intracapsular bag implantation of intraocular aspherical lens was performed. Posterior capsulotomy with neodymium:YAG laser has been performed after 2 months. Final best corrected visual acuity of 1.25 (snellen decimal) has been achieved.

Spontaneous self-absorption of the lens from various etiologies is a very rare entity with less than 50 cases reported worldwide. Correct management of capsular bag remnant allows intraocular lens implantation with good visual outcome.