Management of dislocated lens fragments following phacoemulsification surgery

Twelve patients with retained nuclear lens fragments following phacoemulsification surgery were referred for management. Ocular findings included corneal edema in 4 (33%), elevated intraocular pressure in 6 (50%), vitreous inflammation in 10 (83%) and retinal detachment in 1 (8%). At initial examination 10 of the patients had a visual acuity of 20/200 or less. Two patients were managed conservatively with medical treatment and regained 20/20 and 20/25 vision. Ten patients required pars plana vitrectomy; in six a posterior chamber lens was sutured into the ciliary sulcus after vitrectomy was completed. Postoperatively, 5 of the 10 surgically treated patients regained 20/40 or better vision. Preexisting age-related macular degeneration and chronic cystoid macular edema were the causes of a poor visual result.