Hyperacute iris neovascularization following cataract surgery

RATIONALE: We describe a case of acute neovascularization of the iris after uneventful cataract surgery. PATIENT CONCERNS: A 78-year-old man visited our clinic for cataract surgery and glaucoma management. DIAGNOSES: The patient underwent bilateral laser iridotomy 4 years ago. On ocular examination, the best-corrected visual acuity was no light perception in the right eye and 20/100 in the left eye. We observed pseudophakic bullous keratopathy in the right eye and cataracts and hemicentral retinal vein occlusion (CRVO) in the left eye. INTERVENTIONS: The patient underwent cataract surgery in the left eye without complications. OUTCOMES: The day after surgery we observed 360° of neovascularization in the iris and aggravated hemi-CRVO with macular edema. Therefore, we administered intravitreal bevacizumab in the left eye, after which the iris neovascularization and macular edema improved. LESSONS: Cataract surgery can rapidly aggravate hemi-CRVO and cause iris neovascularization, which is responsive to bevacizumab.