title: Clinical Features and Outcomes of Retained Lens Fragments in the Anterior Chamber After Phacoemulsification.
abstract: OBJECTIVE
  To review the clinical features, treatments, and outcomes of patients with retained lens fragments in the anterior chamber after phacoemulsification with an intact posterior capsule.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  setting: Duke University Eye Center.
  
  
  METHODS
  Fifty-four eyes of 54 patients with a diagnosis of retained lens fragment in the anterior chamber following otherwise uncomplicated phacoemulsification cataract surgery. Patient demographics, clinical examination findings, ocular biometry measurements, treatment received, and pre- and post-lens fragment removal visual acuity were recorded.
  
  
  METHODS
  Corneal edema, time to surgical extraction of lens fragment, and visual acuity.
  
  
  RESULTS
  All lens fragments were located in the inferior angle or the inferior anterior chamber, with 13% of cases requiring gonioscopy for diagnosis. Fifty-six percent of eyes had associated corneal edema, most often located inferiorly. Forty-four percent of patients were initially managed medically, but in all 54 cases the lens fragment was eventually removed surgically. The mean time to removal of the lens fragment from the date of cataract surgery was 70 days (range 1 day-30 months). Five patients had corneal edema that did not resolve following fragment extraction and 3 eventually received an endothelial keratoplasty. Best-corrected visual acuity improved from an average of 20/51 before lens fragment removal to 20/28 after surgical extraction (P < .00001).
  
  
  CONCLUSIONS
  Corneal edema is common in the setting of retained lens fragments and can evolve to corneal decompensation requiring transplantation. Inferior corneal edema, in particular, should alert the practitioner to possible retained lens fragment. Surgical removal of retained lens fragments should be considered at the time of diagnosis.
authors: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina. Electronic address: zacharyzavodni@gmail.com.
authors: Zachary J
authors: ZJ
authors: Zavodni
authors: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
authors: Jay J
authors: JJ
authors: Meyer
authors: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
authors: Terry
authors: T
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology*; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007907:Lens Nucleus, Crystalline / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity