An anomalous foveal OCT-sign after posterior capsule rupture in cataract surgery: Complicated cataract surgery maculopathy

Abstract

Purpose: To report a series of novel optical coherence tomography (SD-OCT) foveal abnormalities, that we called “T-sign,” that were noticed after a complicated cataract surgery with posterior capsule rupture and vitreous loss. Methods: Retrospective case series of persistent foveal changes that incurred after anteroposterior vitreo-foveal traction secondary to phacoemulsification in presence of posterior capsule rupture. Results: The study included three eyes of three patients that incurred in complicated cataract surgery and intraoperative vitreo-foveal traction. During 8-month follow-up period peculiar abnormalities in fundus examination and in OCT scans were reported in all cases. Conclusion: Phacoemulsification in presence of posterior capsule rupture could induce a vitreo-foveal strain that could be transmitted to the cone outer segment tips (COST line) and inner–outer segment (IS/OS) junction. This focal stress is liable for “T-sign,” a persistent SD-OCT abnormality that induce a visual impairment and a slight metamorphopsia in the fixation point. Summary statement All over the world, more than 9.5 million cataract surgeries are completed each year.1 During surgery, many intraoperative complications could occur, and capsule rupture with vitreous loss is a frequent event. Phacoemulsification in presence of a wide posterior capsule rupture and vitreo-macular adhesion could induce a typical modification of the foveal structure and a permanent visual impairment.