Signs, intraoperative challenges, and management strategies during cataract surgery secondary to inadvertent intralenticular antivascular endothelial growth factor injection

We report the case of a 74-year-old woman who attended our outpatient department complaining of decreased vision in her right eye. Three years previously, an intravitreal injection (bevacizumab [Avastin]) had been given for diabetic macular edema. Slitlamp examination showed immature cataract. Preoperative anterior segment optical coherence tomography (AS-OCT) of femtosecond laser–assisted cataract surgery showed a deposit over a potentially compromised posterior lens capsule that was not evident on slitlamp examination. The intraoperative challenges during cataract surgery and the management strategies used for a satisfactory clinical outcome are described. To our knowledge, this is the first report of AS-OCT performed during femtosecond laser–assisted cataract surgery detecting a potentially compromised posterior lens capsule after intravitreal injection.