Argentine Flag Sign

What do flags have to do with cataract surgery? Not much in general! However, there is a special situation in cataract surgery that does. When cataracts get really bad, they turn white. When I do surgery on a bad cataract like that, the surgery starts with a dilated pupil and a white circle staring up at me. In order to successfully complete the surgery, I have to stain the front of the capsule that contains the cataract with a blue dye. Once the stain is done, I have a blue circle staring up at me! The next step is to tear a circular hole in the front of the capsule to give access to the cataract inside. It is important that this hole be circular and doesn’t “run out” to the edge of the cataract. However, sometimes the pressure from the dense cataract inside the capsule is so high that it “pushes” up and causes the tear to “run out.” If the tear spans across the cataract, which it often does, there is a strip of white cataract showing through. Since the rest of the capsule is still there and stained blue, this creates a blue-white-blue pattern that resembles the Argentine flag. This is definitely NOT something I want to see during cataract surgery.