Endoillumination-assisted epithelial downgrowth management with 5-fluorouracil under air tamponade

We describe the management and outcomes of an elderly man with extensive epithelial downgrowth detected 6 months after extracapsular cataract extraction and intraocular lens implantation. Surgery for epithelial membrane removal was performed twice with the use of intracameral 5-flurouracil (5-FU), and the uncorrected distance visual acuity was restored to 20/50. The patient remained recurrence-free at the 3.5-year follow-up. The surgical technique involved meticulous stripping of the epithelial membrane, facilitated by xenon light anterior chamber illumination in combination with repeated 5-FU–ophthalmic viscosurgical device application onto the iris and a final application of 5-FU on the iris under air tamponade for several minutes.