Cataract with posterior capsule rupture following intravitreal injection.

A 35-year-old male presented with complaints of diminution of vision in OD following intravitreal injection of anti-VEGF 1 month back. He was a known case of Pseuxanthoma Elasticum with angioid streaks and choroidal neovascular membrane (CNVM) and had received 8 intravitreal injections in OD and 10 intravitreal injections in OS. On examination, anterior segment of OD showed rosette cataract with posterior capsule rupture [Fig. 1]. Anterior segment of OS was unremarkable. The patient was advised cataract surgery with IOL implantation for OD.

Figure 1

Retro-illumination images showing iatrogenic cataract and defect in posterior capsule (arrows, a). Rosette pattern is appreciable in high magnification images (b)

Intravitreal injections have become the most common intraocular procedure worldwide.[1] Common injection related complications include subconjunctival hemorrhage, endophthalmitis, and retinal detachment. Iatrogenic cataract following intravitreal injection has an incidence of 0.44-- 0.6% and is usually attributable to direct injury with the injection needle.[23]

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