Management of retained intravitreal lens fragments after phacoemulsification surgery.
OBJECTIVE
To evaluate the clinical features of eyes with retained intravitreal lens fragments after phacoemulsification surgery and to assess the guidelines of management and the visual outcome after vitrectomy.


METHODS
Twenty-five consecutive patients referred to our institute for retained intravitreal lens fragments after phacoemulsification cataract surgery were evaluated retrospectively over a 7-year period.


RESULTS
The clinical features of retained lens fragments included deceased visual acuity of 6/60 or worse (68%), uveitis (60%), glaucoma (48%), corneal edema (44%) and retinal detachment in 2 patients (8%). There were 24 patients who underwent pars plana vitrectomy; 1 patient was managed with medical therapy. After vitrectomy, 17 eyes (71%) showed visual improvement, and final visual acuity was 6/12 or better in 13 eyes (54%). The causes of poor final visual outcome of 6/60 or worse included retinal detachment and cystoid macular edema. The time interval between vitrectomy and phacoemulsification was within 4 weeks in 17 patients (71%), ranging from on the same day to 97 days. There was only a trend of better visual outcome in early vitrectomy patients (within 1 week). There was no statistical difference between the initial intraocular lens status and final visual acuity.


CONCLUSIONS
Vitectomy with removal of retained intravitreal lens fragments is beneficial for patients with persistent uveitis and glaucoma after phacoemulsification. In the majority of patients, visual improvement was achieved after vitrectomy. However, poor visual outcome may occur secondary to retinal detachment and cystoid macular edema.
Yang
Chang-Sue
CS
Department of Ophthalmology, Taipei Veterans General Hospital, Taiwan. csyang@vghtpe.gov.tw
Lee
Fenq-Lih
FL
Hsu
Wen-Ming
WM
Liu
Jorn-Hon
JH
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007906:Lens Subluxation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007908:Lens, Crystalline / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity; D014821:Vitrectomy