Subtle signs of zonular damage.

PURPOSE: To describe 5 subtle signs of zonular damage.

SETTING

Cincinnati Eye Institute, Cincinnati, Ohio, USA.

METHODS

Three patients with a history of ocular trauma and 1 patient with Marfan's syndrome are described. During the preoperative examination, subtle signs of zonular damage were detected. As a result of the early recognition, critical modifications in cataract surgery technique and technology were made.

RESULTS

The signs of zonular damage identified in the patients were visibility of the lens equator during eccentric gaze, decentered nucleus in primary position, iridolenticular gap, changes in the contour of the lens periphery, and focal iridodonesis.

CONCLUSION

Identification of subtle but important signs of zonular damage will better prepare the surgeon for a challenging surgical procedure.