Light-induced maculopathy.

Photochemical retinal damage can result from the light of the operating microscope during cataract extraction with implantation of intraocular lenses. Three patients (a 47-year-old woman, a 73-year-old woman, and a 69-year-old man) who underwent cataract extraction with the Zeiss OMNI-6 operating microscope with internal incandescent coaxial illumination developed phototoxic retinal damage in the macular region. A posterior chamber lens was used in the first case, an anterior chamber lens in the second, and an iris-supported lens in the third. The photochemical damage was most evident in fluorescein angiographic studies, and Goldmann visual field studies documented scotomas in the affected areas. Final visual acuities were 20/40 in Case 1, 20/30 in Case 2, and 20/30 in Case 3.