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Management of dislocated nuclear fragments after phacoemulsification
D M Fastenberg1, P L Schwartz, J L Shakin
1Department of Ophthalmology, Long Island Jewish-Hillside Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York.
American Journal of Ophthalmology
|November 15, 1991
Summary
Phacoemulsification can cause dislocated lens fragments, leading to serious eye complications. Prompt management, including vitrectomy, is crucial, but delaying surgery may improve visual outcomes in some cases.
Area of Science:
- Ophthalmology
- Surgical Complications
Background:
- Phacoemulsification is a common cataract surgery technique.
- Dislocation of lens fragments is a known, albeit infrequent, complication.
Purpose of the Study:
- To evaluate outcomes of managing dislocated lens fragments after phacoemulsification.
- To identify factors influencing visual acuity post-complication.
Main Methods:
- Retrospective review of 13 patients with dislocated lens fragments.
- Analysis of ocular findings, surgical interventions (vitrectomy), and visual acuity outcomes.
Main Results:
- Common complications included corneal decompensation, glaucoma, inflammation, and retinal tears/detachments.
- 11 patients underwent vitrectomy; indications were large fragments, uncontrolled glaucoma, severe inflammation, or retinal detachment.
- Better visual acuity was associated with smaller fragments or delayed vitrectomy after medical management of inflammation/glaucoma.
Conclusions:
- Nucleus dislocation during phacoemulsification is a significant cause of visual impairment.
- Management strategies should consider fragment size and the need for medical control of intraocular conditions prior to surgical intervention.