An intra-vitreal injection that accidentally punctures the posterior lens capsule often triggers an acute traumatic white cataract. This occurs because the breach causes rapid hydration and swelling of the lens proteins. Within hours or days, the normally clear lens proteins denature and opacify, leading to a profound drop in vision. Management is surgically demanding. The compromised posterior capsule increases the risk of lens material falling into the vitreous during removal. Surgeons must often employ specialized techniques, such as low-flow phacoemulsification or viscodissection, to stabilize the lens and prevent further capsular tearing. If the rupture is significant, a standard intraocular lens (IOL) may not be feasible, requiring alternative fixation in the sulcus or anterior chamber. And in this case there is retained lens material in the vitreous cavity which will require a full pars plana vitrectomy later. Early intervention is critical to manage secondary glaucoma or inflammation resulting from the leaked lens proteins. Have you encountered a case like this? Please comment below.
