Retained Lens Material With Decompensated Cornea 14 Years After Lens Aspiration And Anterior Vitrectomy

Published 2022 - 40th Congress of the ESCRS

Reference: CC02.06 | Type: Case report | DOI: 10.82333/2dnx-h015

Authors: Ghadah Mohammed Alqahtani* ¹ , Halah Bin Helayel ² , Faisal Alotaibi ³ , Mohammed Almutlak ⁴

¹Fellowship and Residency Training Program,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, ²Anterior Segment Division,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, ³King Abdulaziz Specialist Hospital,Taif,Saudi Arabia, ⁴Anterior Segment Division,King Khaled Eye Specialist Hospital,Riyadh ,Saudi Arabia

Presence of retained lens material is a rare complication after lens aspiration in congenital cataract cases. Retained lens material is known to be linked with a risk of endothelial damage resulting in corneal edema, intraocular inflammation, cystoid macular edema, retinal detachment, secondary glaucoma, and decreased vision. Keeping remnant lens material one of the differential diagnoses when evaluating symptomatic aphakic patients is crucial to prevent such complications.

The case presented to the emergency department of a tertiary eye care hospital in Riyadh, Saudi Arabia. The initial cataract surgery was also performed in the same hospital.

A 20 years old man underwent bilateral lens aspiration and anterior vitrectomy 14 years ago for bilateral congenital cataract. IOL implantation was not performed due to myopia.

He presented to our emergency room with right eye pain, redness and blurry vision. He reported recurrent bouts of similar symptoms in the same eye for years.

Upon examination of the right eye, uncorrected vision was 6/200 that improved to 20/400. The intraocular pressure was 18.5 millimeter of mercury. Diffuse corneal edema with bullae was noted, and a C- shaped lens material was seen in the anterior chamber of the right eye. When the patient was re-assessed for dilated fundus examination in the same visit, the lens material had migrated from anterior chamber to the vitreous cavity.

The left eye examination showed a quite aphakic eye.

This case report highlights the importance of considering complications related to remnant lens fragments in symptomatic aphakic patients, regardless of the cataract surgery time. In such cases, IOL can serve as a protective barrier for corneal endothelium in case lens fragments retained in vitreous cavity.