“Triangle sign” in Morgagnian cataract

Morgagnian cataract (MC), named after the Italian anatomist anatomist, Giovanni B. Morgagni, is a cataract in which there is liquefaction of the cortex and sinking of the dense nucleus in the capsular bag.[¹²] In some cases, liquified cortical matter gets completely resorbed leaving behind just the transparent lens capsule superiorly and the dense nucleus in the bag inferiorly. This may be confused with inferiorly subluxated cataractous lens due to superior zonular dialysis. A 65-year-old female presented with diminution of vision in the right eye for 6 months. Slit lamp examination showed clear zone superiorly and a nucleus inferiorly [Fig. 1a]. On 10× magnification, a triangular space was observed just above the nucleus [Fig. 1b]. Thus, a diagnosis of MC with resorbed cortex was made on the basis of “Triangle sign.” She underwent successful phacoemulsification with in the bag intraocular lens implantation. This image highlights the importance of “Triangle sign” in differentiating MC from inferiorly subluxated lens and deciding further course of surgical management.

Figure 1: (a) Slit lamp optical section showing morgagnian cataract with resorbed cortex and sunken dense nucleus. “Triangle sign” (Triangular space) seen just superior to the nucleus. (b) Magnified image (10×) of the “Triangle sign” (arrow)

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Acknowledgement

We would like to thank Sri Kanchi Sankara Health and Educational Foundation, Guwahati, India.