Macular phototoxic injury due to cataract extraction and trifocal intraocular lens implantation

A 53-year-old woman underwent to the right uncomplicated cataract surgery and a trifocal intraocular lens (IOL) implan-tation. Twenty-six days after the surgery, the patient was admitted to our department with reduced vision. Slit-lamp exam-ination of anterior chamber showed a clear cornea with deep anterior chamber and a centralized IOL. Fundus examina-tion showed macular hole-like lesion in the fovea. Optic coherence tomography showed parafoveal edema, photoreceptor integrity line disruption, and outer retinal atrophy in the fovea. Fluorescein angiography showed corresponding areas of hyperfluorescence without leakage, consistent with phototoxic maculopathy resulting from the operating microscope. She had been diagnosed with systemic lupus erythematosus (SLE) 10 years ago. We aimed to present a patient who had pro-found visual loss secondary to presumed macular phototoxicity following cataract extraction and IOL implantation possibly related to underlying SLE. Patients with SLE may be prone to phototoxic damage during eye surgery.