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An unexpected 'Argentinian Flag' on a non-intumescent cataract

Poster Details

First Author: R.Tan SINGAPORE

Co Author(s):    J. Lim                    

Abstract Details

Purpose:

A case write up on a rare occurrence of spontaneous anterior capsular split (Argentinian Flag Sign) on a non-intumescent cataract during phacoemulsification cataract surgery.

Setting:

Tan Tock Seng Hospital, Ophthalmology Department, Singapore

Methods:

A 62 year old Indian lady was listed for right eye phacoemulsification cataract surgery and intraocular lens implantation on 25 July 2016. She was last reviewed in the clinic on 19 May 2016, with a best corrected visual acuity of 6/18 on the right eye, with a cataract of nuclear sclerosis 3, cortical 1 and posterior subcapsular 3, with no obvious phacodonesis. After the initiation of the continuous curvilinear capsulorhexis, the anterior capsule started to split spontaneously, eventually resulting in an 'Argentinian flag'.

Results:

It was after the conversion and removal of the cataract via extracapsular cataract extraction, that a dense stellate fibrous scar was seen on the posterior capsule. Further questioning revealed that the patient previously had trauma to her eyes. We postulated that there may be a possible small breach in the posterior capsule secondary to trauma to the eye, which self-sealed, causing a dense fibrous scar. The fibrous scar may have created tension on the anterior capsule that resulted in the 'Argentinian flag'.

Conclusions:

'Argentinian flag' resulting from a non-intumescent cataract is a rare occurrence. In our case, we suspect that a dense fibrous scar in the posterior capsule modified the tension of the anterior capsule, leading to the 'Argentinian flag'. Surgeons should be aware of such a possible situation, and it is essential to obtain a history of trauma to the eyes prior to cataract surgery, and to examine the lens and the capsule carefully for any signs of breach or fibrosis.

Financial Disclosure:

NONE

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