Occurrence of retained lens fragments after phacoemulsification in The Netherlands
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 ret...
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Published in | Journal of cataract and refractive surgery Vol. 23; no. 8; pp. 1177 - 1182 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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New York, NY
Elsevier Inc
01.10.1997
Elsevier Science |
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Abstract | 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. |
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AbstractList | To determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this complication.
Eleven vitreoretinal centers in The Netherlands.
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.
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.
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. 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. PURPOSETo determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this complication.SETTINGEleven vitreoretinal centers in The Netherlands.METHODSWe 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.RESULTSThe 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.CONCLUSIONSThe 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. |
Author | Stilma, Jan S. van Meurs, Jan C. van der Sluijs, Frank A. Mertens, Diana A.E. |
Author_xml | – sequence: 1 givenname: Jan S. surname: Stilma fullname: Stilma, Jan S. organization: From Donders Institute of Ophthalmology, University of Utrecht, The Netherlands – sequence: 2 givenname: Frank A. surname: van der Sluijs fullname: van der Sluijs, Frank A. organization: From Donders Institute of Ophthalmology, University of Utrecht, The Netherlands – sequence: 3 givenname: Jan C. surname: van Meurs fullname: van Meurs, Jan C. organization: Eye Hospital Rotterdam, The Netherlands – sequence: 4 givenname: Diana A.E. surname: Mertens fullname: Mertens, Diana A.E. organization: Eye Hospital Rotterdam, The Netherlands |
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Cites_doi | 10.1038/eye.1995.102 10.1016/S0161-6420(92)31814-7 10.1016/S0161-6420(94)31094-3 10.1016/S0161-6420(92)32003-2 10.1016/0002-9394(60)92044-4 10.1016/S0002-9394(14)76247-6 10.1055/s-2008-1035487 10.1016/S0002-9394(42)92398-5 10.1097/00006982-199212040-00002 10.1016/S0161-6420(92)31805-6 10.1001/archopht.1977.04450100069004 |
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Copyright | 1997 American Society of Cataract and Refractive Surgery and European Society of Cataract and Refractive Surgeons. All rights reserved 1998 INIST-CNRS |
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Keywords | Human Postoperative Cataract Treatment efficiency Phacoemulsification Retention Fragment Incidence Eye disease Lens disease Treatment Surgery Complication Vitrectomy Lens Anterior segment disease |
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References | Chern, Yung (bib17) 1995; 26 Topping (bib18) 1992; 99 Gilliland, Hutton, Fuller (bib2) 1992; 99 Kim, Flynn, Smiddy (bib4) 1994; 101 Michels, Shracklett (bib11) 1977; 95 Tommila, Immonen (bib13) 1995; 9 Toczolowski (bib5) 1987; 18 Liu, Peyman, Chen, Chang (bib6) 1991; 22 Van Effenterre, Le Mer, Lacotte, Ameline (bib9) 1992; 15 Lewis, Blumenkranz, Chang (bib10) 1992; 12 Worst (bib15) 1988 Shapiro, Resnick, Kim, Weinberg (bib7) 1991; 112 Röver (bib12) 1995; 206 Blodi, Flynn, Blodi (bib1) 1992; 99 Binkhorst (bib14) 1960; 49 Korobelnik, Nabet, Elmaleh (bib8) 1992; 15 Verhoeff (bib16) 1942; 25 Lambrou, Stewart (bib3) 1992; 99 Lambrou (10.1016/S0886-3350(97)80312-4_bib3) 1992; 99 Lewis (10.1016/S0886-3350(97)80312-4_bib10) 1992; 12 Michels (10.1016/S0886-3350(97)80312-4_bib11) 1977; 95 Van Effenterre (10.1016/S0886-3350(97)80312-4_bib9) 1992; 15 Röver (10.1016/S0886-3350(97)80312-4_bib12) 1995; 206 Binkhorst (10.1016/S0886-3350(97)80312-4_bib14) 1960; 49 Blodi (10.1016/S0886-3350(97)80312-4_bib1) 1992; 99 Gilliland (10.1016/S0886-3350(97)80312-4_bib2) 1992; 99 Tommila (10.1016/S0886-3350(97)80312-4_bib13) 1995; 9 Toczolowski (10.1016/S0886-3350(97)80312-4_bib5) 1987; 18 Topping (10.1016/S0886-3350(97)80312-4_bib18) 1992; 99 Verhoeff (10.1016/S0886-3350(97)80312-4_bib16) 1942; 25 Chern (10.1016/S0886-3350(97)80312-4_bib17) 1995; 26 Korobelnik (10.1016/S0886-3350(97)80312-4_bib8) 1992; 15 Kim (10.1016/S0886-3350(97)80312-4_bib4) 1994; 101 Liu (10.1016/S0886-3350(97)80312-4_bib6) 1991; 22 Shapiro (10.1016/S0886-3350(97)80312-4_bib7) 1991; 112 Worst (10.1016/S0886-3350(97)80312-4_bib15) 1988 |
References_xml | – volume: 206 start-page: 456 year: 1995 end-page: 459 ident: bib12 article-title: Phakoemulsification des abgesunkenen Linsenkernes im Glaskörperraum publication-title: Klin Monatsbl Augenheilkd contributor: fullname: Röver – volume: 9 start-page: 437 year: 1995 end-page: 441 ident: bib13 article-title: Dislocated nuclear fragments after cataract surgery publication-title: Eye contributor: fullname: Immonen – year: 1988 ident: bib15 publication-title: Implantation of the lobster claw (iris claw) lens contributor: fullname: Worst – volume: 12 start-page: 299 year: 1992 end-page: 304 ident: bib10 article-title: Treatment of dislocated crystalline lens and retinal detachment with perfluorocarbon liquids publication-title: Retina contributor: fullname: Chang – volume: 26 start-page: 114 year: 1995 end-page: 116 ident: bib17 article-title: Posterior lens dislocation during attempted phacoemulsification publication-title: Ophthalmic Surg contributor: fullname: Yung – volume: 99 start-page: 1268 year: 1992 end-page: 1269 ident: bib18 article-title: Discussion of paper by Gilliland GD, Hutton WL, Fuller DG publication-title: Ophthalmology contributor: fullname: Topping – volume: 22 start-page: 503 year: 1991 end-page: 507 ident: bib6 article-title: Use of high-density vitreous substitutes in the removal of posteriorly dislocated lenses or intraocular lenses publication-title: Ophthalmic Surg contributor: fullname: Chang – volume: 99 start-page: 41 year: 1992 end-page: 44 ident: bib1 article-title: Retained nuclei after cataract surgery publication-title: Ophthalmology contributor: fullname: Blodi – volume: 99 start-page: 1260 year: 1992 end-page: 1262 ident: bib3 article-title: Management of dislocated lens fragments during phacoemulsification publication-title: Ophthalmology contributor: fullname: Stewart – volume: 112 start-page: 401 year: 1991 end-page: 405 ident: bib7 article-title: Management of the dislocated crystalline lens with a perfluorocarbon liquid publication-title: Am J Ophthalmol contributor: fullname: Weinberg – volume: 18 start-page: 214 year: 1987 end-page: 216 ident: bib5 article-title: The use of sodium hyaluronate (Hyalcon) for the removal of severely subluxated lenses publication-title: Ophthalmic Surg contributor: fullname: Toczolowski – volume: 15 start-page: 235 year: 1992 end-page: 242 ident: bib8 article-title: Utilisation des perfluorocarbones liquides daps le traitement chirurgical des luxations postérieures du cristallin publication-title: J Fr Ophtalmol contributor: fullname: Elmaleh – volume: 99 start-page: 1263 year: 1992 end-page: 1267 ident: bib2 article-title: Retained intravitreal lens fragments after cataract surgery publication-title: Ophthalmology contributor: fullname: Fuller – volume: 25 start-page: 725 year: 1942 ident: bib16 article-title: A simple and safe method for removing a cataract dislocated into fluid vitreous (note) publication-title: Am J Ophthalmol contributor: fullname: Verhoeff – volume: 101 start-page: 1827 year: 1994 end-page: 1832 ident: bib4 article-title: Retained lens fragments after phacoemulsification publication-title: Ophthalmology contributor: fullname: Smiddy – volume: 15 start-page: 337 year: 1992 end-page: 342 ident: bib9 article-title: Luxation postérieure du cristallin ou d'un implant; 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traitement chirurgical utilisant un perfluorocarbone liquide; technique et résultats à propos de 13 cas publication-title: J Fr Ophtalmol contributor: fullname: Van Effenterre – volume: 99 start-page: 41 year: 1992 ident: 10.1016/S0886-3350(97)80312-4_bib1 article-title: Retained nuclei after cataract surgery publication-title: Ophthalmology doi: 10.1016/S0161-6420(92)32003-2 contributor: fullname: Blodi – volume: 26 start-page: 114 year: 1995 ident: 10.1016/S0886-3350(97)80312-4_bib17 article-title: Posterior lens dislocation during attempted phacoemulsification publication-title: Ophthalmic Surg contributor: fullname: Chern – volume: 18 start-page: 214 year: 1987 ident: 10.1016/S0886-3350(97)80312-4_bib5 article-title: The use of sodium hyaluronate (Hyalcon) for the removal of severely subluxated lenses publication-title: Ophthalmic Surg contributor: fullname: Toczolowski – volume: 99 start-page: 1268 year: 1992 ident: 10.1016/S0886-3350(97)80312-4_bib18 article-title: Discussion of paper by Gilliland GD, Hutton WL, Fuller DG publication-title: Ophthalmology contributor: fullname: Topping – volume: 49 start-page: 703 year: 1960 ident: 10.1016/S0886-3350(97)80312-4_bib14 article-title: Results of implantation of intraocular lenses in unilateral aphakia, with special reference to the pupillary or iris clip lens—a new method of fixation publication-title: Am J Ophthalmol doi: 10.1016/0002-9394(60)92044-4 contributor: fullname: Binkhorst – volume: 112 start-page: 401 year: 1991 ident: 10.1016/S0886-3350(97)80312-4_bib7 article-title: Management of the dislocated crystalline lens with a perfluorocarbon liquid publication-title: Am J Ophthalmol doi: 10.1016/S0002-9394(14)76247-6 contributor: fullname: Shapiro – volume: 206 start-page: 456 year: 1995 ident: 10.1016/S0886-3350(97)80312-4_bib12 article-title: Phakoemulsification des abgesunkenen Linsenkernes im Glaskörperraum publication-title: Klin Monatsbl Augenheilkd doi: 10.1055/s-2008-1035487 contributor: fullname: Röver – volume: 25 start-page: 725 year: 1942 ident: 10.1016/S0886-3350(97)80312-4_bib16 article-title: A simple and safe method for removing a cataract dislocated into fluid vitreous (note) publication-title: Am J Ophthalmol doi: 10.1016/S0002-9394(42)92398-5 contributor: fullname: Verhoeff – volume: 12 start-page: 299 year: 1992 ident: 10.1016/S0886-3350(97)80312-4_bib10 article-title: Treatment of dislocated crystalline lens and retinal detachment with perfluorocarbon liquids publication-title: Retina doi: 10.1097/00006982-199212040-00002 contributor: fullname: Lewis – year: 1988 ident: 10.1016/S0886-3350(97)80312-4_bib15 contributor: fullname: Worst – volume: 99 start-page: 1260 year: 1992 ident: 10.1016/S0886-3350(97)80312-4_bib3 article-title: Management of dislocated lens fragments during phacoemulsification publication-title: Ophthalmology doi: 10.1016/S0161-6420(92)31805-6 contributor: fullname: Lambrou – volume: 95 start-page: 1767 year: 1977 ident: 10.1016/S0886-3350(97)80312-4_bib11 article-title: Vitrectomy technique for removal of retained lens material publication-title: Arch Ophthalmol doi: 10.1001/archopht.1977.04450100069004 contributor: fullname: Michels |
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Snippet | Purpose: To determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this... To determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this... PURPOSETo determine the incidence of retained lens fragments after phacoemulsification in The Netherlands and to evaluate the effect of vitrectomy on this... |
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SubjectTerms | 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 |
Title | Occurrence of retained lens fragments after phacoemulsification in The Netherlands |
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