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Minerva Oftalmologica 2009 June;51(2):49-58

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Outcome of management of dropped crystalline lens and their fragments after phacoemulsification

Qureshi W. 1, Haider S. A. 2, Ahmed F. 3

1 MRCOPHTH(UK) PGR Ophthalmology Department Lahore General Hospital, Lahore, Pakistan
2 FRCS(UK) Department of Ophthalmology Lahore General Hospital, Lahore, Pakistan
3 PGR Ophthalmology Lahore General Hospital, Lahore, Pakistan


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Aim. To evaluate the surgical management and visual outcome of retained Intravitreal lens fragments after phacoemulsification surgery. To investigate the incidence of cystoid macular edema, retinal detachment, suprachoroidal hemorrhage and any other complications in patients of pars plana vitrectomy for retained intravitreal lens fragments. This study was carried out at the Department of Ophthalmology, Lahore General Hospital, Lahore.
Methods. Descriptive prospective study of patients having retained intravitreal lens fragments after phacoemulsification surgery. Three port pars plana vitrectomy was carried out for retained intravitreal lens fragments. Incidence of cystoid macular edema, retinal detachment, suprachoroidal hemorrhage and any other complications in patients of pars plana vitrectomy for retained intravitreal lens fragments; 15 eyes having retained lens matter after phacoemulsification surgery were included.
Results. Aphakia was present in 10 (66.75%) patients 5 (33.4%) patients were pseudophakic. Raised intraocular pressure was found in 11 (73.4%) patients, corneal edema in 7 (46.7%), uveitis in 6 (40%) patients. Two (13.4%) patients had retinal detachment on presentation. The range of visual acuity was perception and projection of light to counting fingers in 9 (60%), 2/60-6/60 in 5 (33.4%), 6/24 in 1 (6.64%) eyes preoperatively. After vitrectomy, range of visual acuity was 6/9 to 6/18 in 9 (60%) and 6/24-6/60 in 6 (40%) patients comparison of pre-operative visual acuity and of last follow-up show p<0.001 (statistically highly significant). Intraocular pressure was raised in only 2 (13.3%) no one developed retinal detachment. Cystoid macular edema was found in only 2 (13.4%) and no significant intraocular inflammation was observed in any patient.
Conclusions. Patients who had dropped intravitreal lens matter presented with raised intraocular pressure, reduced visual acuity, uveitis and retinal detachment. In such patients combined pars plana vitrectomy and secondary intraocular lens implantation reduced the risk of postoperative complications including secondary glaucoma, uveitis and helped in restoration of useful visual acuity.

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