PMC6324160_01
Slit lamp photograph (a). Diffuse illumination showing traumatic mydriasis, a posterior synechiae at 12 "o" clock position, and a demarcated posterior subcapsular cataract (b). Focal slit illumination showing backward deviation of slit beam at the level of posterior capsule in the area of cataract (white arrows), increased opacification of posterior capsule at the margins of cataract, and wrinkling of posterior capsule at the superior margin (black arrows). (c) Diffuse illumination showing total cataract and visible lens edge in the inferior 2 o'clock hours
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F1
A diffuse slit lamp illumination showed a demarcated semicircular cataract in the inferior part of the lens [Fig. 1a] with a broad slit showing backward deviation of the beam at the level of posterior capsule (PC) [Fig. 1b]. After 2 weeks on antiglaucoma agents, the patient presented with total cataract [Fig. 1c] when phacoemulsification with intraocular lens implantation in bag was carried out.
Anterior segment optical coherence tomography image (vertical section) showing intact and ectatic posterior capsule with layering of posterior capsule in the superior area (arrows)
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F2
Further evaluation with anterior segment optical coherence tomography (ASOCT) showed an ectatic PC in the area of demarcated cataract [Fig. 2] and a provisional diagnosis of posterior lenticonus was thus made.
Anterior segment optical coherence tomography image (vertical section) showing intraocular lens in bag and posterior capsule folds (arrows) in the area of previous lenticonus
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F3
After surgery, unaided VA was 20/30 and ASOCT showed PC folds [Fig. 3].