Abstract
Objective: To review the clinical features and treatment of patients with retained nuclear fragments in the anterior chamber (AC). Design: Single-center, retrospective, noncomparative, consecutive case series. Participants: Sixteen patients with a diagnosis of retained nuclear fragments in the AC. Methods: Retrospective review of the medical records at Bascom Palmer Eye Institute in Miami, Florida, to identify all patients with a diagnosis of retained nuclear fragments in the AC after phacoemulsification surgery without rupture of the posterior capsule. Charts were reviewed and patient characteristics, ocular history, clinical findings, treatment (medical and surgical), and visual outcomes were recorded. Main Outcome Measures: Visual outcome and visual acuity at last follow-up visit. Results: Most patients presented with corneal edema and anterior segment inflammation. All patients proved refractory to medical management, and surgical extraction of the retained lens fragment was required. Ten patients were myopic or had long axial lengths and/or steep keratometry readings. Three patients underwent penetrating keratoplasty for intractable corneal edema. One patient required a second surgery for fragment removal after a previous unsuccessful attempt at removal. Visual outcomes for the patients without macular disease who had lens fragment removal alone ranged from 20/20 to 20/40. Of the 2 patients without macular disease who underwent penetrating keratoplasty, the visual outcomes were 20/50 and 20/30. Conclusions: Retention of nuclear fragments in the AC may occur after phacoemulsification. This complication was associated with myopia in a majority of patients in this series, and we hypothesize that small fragments may hide in the posterior chamber in these larger eyes. Surgical removal was associated with a good visual outcome in patients without macular disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1949-1953 |
| Number of pages | 5 |
| Journal | Ophthalmology |
| Volume | 113 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2006 |
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ASJC Scopus subject areas
- Ophthalmology
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Retained Nuclear Fragments in the Anterior Chamber after Phacoemulsification with an Intact Posterior Capsule. / Hui, Jennifer I.; Fishler, Jane; Karp, Carol; Shuler, Magdalena F.; Gedde, Steven J.
In: Ophthalmology, Vol. 113, No. 11, 01.11.2006, p. 1949-1953.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Retained Nuclear Fragments in the Anterior Chamber after Phacoemulsification with an Intact Posterior Capsule
AU - Hui, Jennifer I.
AU - Fishler, Jane
AU - Karp, Carol
AU - Shuler, Magdalena F.
AU - Gedde, Steven J
PY - 2006/11/1
Y1 - 2006/11/1
N2 - Objective: To review the clinical features and treatment of patients with retained nuclear fragments in the anterior chamber (AC). Design: Single-center, retrospective, noncomparative, consecutive case series. Participants: Sixteen patients with a diagnosis of retained nuclear fragments in the AC. Methods: Retrospective review of the medical records at Bascom Palmer Eye Institute in Miami, Florida, to identify all patients with a diagnosis of retained nuclear fragments in the AC after phacoemulsification surgery without rupture of the posterior capsule. Charts were reviewed and patient characteristics, ocular history, clinical findings, treatment (medical and surgical), and visual outcomes were recorded. Main Outcome Measures: Visual outcome and visual acuity at last follow-up visit. Results: Most patients presented with corneal edema and anterior segment inflammation. All patients proved refractory to medical management, and surgical extraction of the retained lens fragment was required. Ten patients were myopic or had long axial lengths and/or steep keratometry readings. Three patients underwent penetrating keratoplasty for intractable corneal edema. One patient required a second surgery for fragment removal after a previous unsuccessful attempt at removal. Visual outcomes for the patients without macular disease who had lens fragment removal alone ranged from 20/20 to 20/40. Of the 2 patients without macular disease who underwent penetrating keratoplasty, the visual outcomes were 20/50 and 20/30. Conclusions: Retention of nuclear fragments in the AC may occur after phacoemulsification. This complication was associated with myopia in a majority of patients in this series, and we hypothesize that small fragments may hide in the posterior chamber in these larger eyes. Surgical removal was associated with a good visual outcome in patients without macular disease.
AB - Objective: To review the clinical features and treatment of patients with retained nuclear fragments in the anterior chamber (AC). Design: Single-center, retrospective, noncomparative, consecutive case series. Participants: Sixteen patients with a diagnosis of retained nuclear fragments in the AC. Methods: Retrospective review of the medical records at Bascom Palmer Eye Institute in Miami, Florida, to identify all patients with a diagnosis of retained nuclear fragments in the AC after phacoemulsification surgery without rupture of the posterior capsule. Charts were reviewed and patient characteristics, ocular history, clinical findings, treatment (medical and surgical), and visual outcomes were recorded. Main Outcome Measures: Visual outcome and visual acuity at last follow-up visit. Results: Most patients presented with corneal edema and anterior segment inflammation. All patients proved refractory to medical management, and surgical extraction of the retained lens fragment was required. Ten patients were myopic or had long axial lengths and/or steep keratometry readings. Three patients underwent penetrating keratoplasty for intractable corneal edema. One patient required a second surgery for fragment removal after a previous unsuccessful attempt at removal. Visual outcomes for the patients without macular disease who had lens fragment removal alone ranged from 20/20 to 20/40. Of the 2 patients without macular disease who underwent penetrating keratoplasty, the visual outcomes were 20/50 and 20/30. Conclusions: Retention of nuclear fragments in the AC may occur after phacoemulsification. This complication was associated with myopia in a majority of patients in this series, and we hypothesize that small fragments may hide in the posterior chamber in these larger eyes. Surgical removal was associated with a good visual outcome in patients without macular disease.
UR - http://www.scopus.com/inward/record.url?scp=33750330013&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33750330013&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2006.03.066
DO - 10.1016/j.ophtha.2006.03.066
M3 - Article
C2 - 16935342
AN - SCOPUS:33750330013
VL - 113
SP - 1949
EP - 1953
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 11
ER -