Focal multistriae: postoperative finding in posterior lenticonus patients

A brother and sister presented with a history of difficulty reading fine print and an intolerance to glare. Family history was positive for bilateral posterior lenticonus in the mother. Biomicroscopy confirmed that each sibling had bilateral posterior lenticonus that was more easily diagnosed in the brother. Uneventful phacoemulsification was performed in each eye with a foldable acrylic posterior chamber intraocular lens (IOL) placed vertically within the capsular bag in 3 eyes and horizontally in 1 eye. On the day after surgery, biomicroscopy revealed vertical wrinkles limited to the central 2.0 mm of the posterior capsule corresponding to the cone in the eyes in which the IOLs had been vertically placed. We hypothesize that these striae occurred within the cone as a result of redistributing the usual mechanical forces associated with capsule stretch between the most distal contact points of the haptics. We believe that the appearance of these multiple striae limited to the central posterior capsule represents an unreported postoperative finding associated with posterior lenticonus.