OCCURRENCE OF RETAINED LENS FRAGMENTS AFTER PHACOEMULSIFICATION IN THE NETHERLANDS

Purpose: To determine the incidence of retained lens fragments after p hacoemulsification in The Netherlands and to evaluate the effect of vi trectomy on this complication. Setting: Eleven vitreoretinal centers i n The Netherlands. Methods: We performed a retrospective analysis of a ll patients with retained lens fragments (N = 70) who were referred fo r vitreoretinal surgery to 11 specialized centers. Seven patients (10% ) were treated with medication alone, and 63 (90%) had pars plana vitr ectomy. 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 dur ing the learning curve and with experienced surgeons. After medical or surgical treatment, visual acuity was 20/40 or better in 43 of 70 pat ients (61%). Uveitis disappeared in all cases. Retinal detachment occu rred in 10 patients (14%). Attached retinal breaks were treated in an additional 5 patients. Corneal grafting was performed in 2 patients. P atients who had immediate vitrectomy did not have better functional re sults than patients in whom vitrectomy was delayed. The iris-fixated c law lens was implanted successfully when capsular support was insuffic ient. Conclusions: The introduction of phacoemulsification in The Neth erlands is associated with an increase of patients with retained lens fragments. Retained lens fragments are complicated by an increased ris k for retinal detachment and corneal decompensation. Vitrectomy result ed in a marked improvement of visual acuity and clearing of uveitis.