Retained lens fragments in resident-performed cataract extractions.
OBJECTIVE
To investigate the incidence, management, and outcome of retained lens fragments following resident-performed cataract extraction.


METHODS
A retrospective review of all eyes undergoing cataract extraction by the residents of Baylor College of Medicine over a 4-year time frame (July/95-June/99).


RESULTS
A total of 3389 eyes underwent cataract extraction, and 26 patients (0.8%) required pars plana vitrectomy (PPV) for retained lens fragments. One or more vision threatening complications occurred in 19 (73%) of these patients. The most common complications were cystoid macular edema (CME) (8 eyes, 31%) and rhegmatogenous retinal detachment (RRD) formation (6 eyes, 23%). Additional surgical procedures were required for 9 (35%) eyes; the most common were repeat PPV, and placement of focal photocoagulation for diabetic macular edema (4 eyes per each procedure, 15%). Six-month follow-up was available for 16 eyes; of these, best-corrected visual acuity was 20/40 or better in 5 (31%) and 20/200 or worse in 7 (44%). The most common reasons for limited visual acuity were RRD (3 eyes, 19%) and CME (3 eyes, 19%).


CONCLUSIONS
In this retrospective series, the incidence of retained lens fragments following resident-performed cataract extraction was less than 1%. Significant complications, resulting in the need for additional surgical procedures, occurred in most of these eyes, and this was associated with limited visual function at final follow-up. Retention of lens fragments following resident-performed cataract extraction remains an infrequent yet serious complication associated with a guarded visual prognosis.
Schwartz
Stephen G
SG
Department of Ophthalmology, Medical College, Virginia Campus of Virginia Commonwealth University, Richmond, USA.
Holz
Eric R
ER
Mieler
William F
WF
Kuhl
Derek P
DP
D002387:Cataract Extraction / Q000009:adverse effects*; D002983:Clinical Competence; D006801:Humans; D015994:Incidence; D007396:Internship and Residency; D007906:Lens Subluxation / Q000209:etiology* / Q000601:surgery; D008269:Macular Edema / Q000209:etiology / Q000601:surgery; D009885:Ophthalmology / Q000193:education*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy