Postoperative Inflammatory “Cocoon” Membrane Following Phacoemulsification: A Distinct Clinical Entity
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT330 | Type: Poster | DOI: 10.82333/1ct2-mc79
Authors: Dr Ioannis Keramidas* 1 , Dr Melpomeni Zartaloudi 1 , Dr Eleutherios Loukovitis 1 , Dr Dimitra Tzakri 1 , Dr Nikolaos Kourtis 1
1424 General Military Hospital of Thessaloniki,Thessaloniki,Greece
Purpose
To describe a rare case of postoperative inflammatory “cocoon” membrane formation following uncomplicated phacoemulsification and to highlight its differential diagnosis and management strategy.
Setting
Department of Ophthalmology, 424 General Military Hospital of Thessaloniki, Greece
Methods
A 72-year-old male underwent uneventful phacoemulsification with posterior chamber intraocular lens implantation in the right eye. On postoperative day 5, the patient presented with decreased visual acuity, οcular pain, conjunctival hyperemia. Slit-lamp examination revealed a dense inflammatory membrane surrounding the intraocular lens in a cocoon configuration. Anterior segment optical coherence tomography (AS-OCT) was performed to document the membrane morphology and its spatial relationship to the IOL. No signs suggestive of endophthalmitis were observed.
Results
The patient received one intraocular antibiotic injection, intensive topical corticosteroid therapy. Clinical improvement was observed progressively and complete regression of the inflammatory membrane occurred within 15 days. AS-OCT imaging confirmed gradual resolution of the membrane.
Conclusions
Inflammatory “cocoon” membrane formation represents a rare postoperative complication after cataract surgery. It may mimic Toxic Anterior Segment Syndrome (TASS) or endophthalmitis. Careful clinical assessment and imaging are crucial for differential diagnosis. Aggressive topical corticosteroid therapy appears to be the mainstay of treatment. Prognosis is favorable with prompt recognition and management.