Occurrence of retained lens fragments after phacoemulsification in The Netherlands

• Published in: Journal of cataract and refractive surgery Vol. 23; no. 8; pp. 1177 - 1182
• Main Authors: Stilma, Jan S., van der Sluijs, Frank A., van Meurs, Jan C., Mertens, Diana A.E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.1997; Elsevier Science
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Clinical Competence; Female; Follow-Up Studies; Humans; Incidence; Intraoperative Complications - epidemiology; Intraoperative Complications - etiology; Intraoperative Complications - surgery; Lens Implantation, Intraocular; Lens Subluxation - epidemiology; Lens Subluxation - etiology; Lens Subluxation - surgery; Male; Medical sciences; Middle Aged; Netherlands - epidemiology; Phacoemulsification - adverse effects; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity; Vitrectomy; Netherlands; Europe; Human; Postoperative; Cataract; Treatment efficiency; Phacoemulsification; Retention; Fragment; Incidence; Eye disease; Lens disease; Treatment; Surgery; Complication; Vitrectomy; Lens; Anterior segment disease
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/S0886-3350(97)80312-4

Purpose: To determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this complication. Setting: Eleven vitreoretinal centers in The Netherlands. Methods: We performed a retrospective analysis of all patients with retained lens fragments (N = 70) who were referred for vitreoretinal surgery to 11 specialized centers. Seven patients (10%) were treated with medication alone, and 63 (90%) had pars plana vitrectomy. Minimum follow-up after vitrectomy was 3 months. Results: The incidence of retained lens fragments in The Netherlands was calculated at 0.9/1000 cataract operations. Retained lens fragments occurred during the learning curve and with experienced surgeons. After medical or surgical treatment, visual acuity was 20/40 or better in 43 of 70 patients (61%). Uveitis disappeared in all cases. Retinal detachment occurred in 10 patients (14%). Attached retinal breaks were treated in an additional 5 patients. Corneal grafting was performed in 2 patients. Patients who had immediate vitrectomy did not have better functional results than patients in whom vitrectomy was delayed. The iris-fixated claw lens was implanted successfully when capsular support was insufficient. Conclusions: The introduction of phacoemulsification in The Netherlands is associated with an increase of patients with retained lens fragments. Retained lens fragments are complicated by an increased risk for retinal detachment and corneal decompensation. Vitrectomy resulted in a marked improvement of visual acuity and clearing of uveitis.