Delayed presentation of retained nuclear fragment following phacoemulsification cataract extraction

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Abstract

An 87-year-old woman presented 11 months after routine phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her left eye complaining of the abrupt onset of redness and decreased vision in that eye. Examination revealed a mild anterior chamber reaction and significant corneal edema. The eye was minimally responsive to topical steroid therapy, and initial serial slitlamp examinations with gonioscopy were unrevealing. After multiple head-positioning maneuvers were performed, a retained nuclear fragment was uncovered. The nuclear fragment was aspirated and liquefied by the phacoemulsification device in the anterior chamber. A retained nuclear fragment with an intact posterior capsule is a recognized cause of inflammation in the immediate postoperative presentation. Delayed presentation of symptoms is rare and presumably secondary to sequestration of the fragment behind the iris. We present a case and a review of the literature regarding sequestered retained nuclear fragments following what is initially thought to be uneventful cataract extraction. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish (US)
Pages (from-to)671-674
Number of pages4
JournalJournal of Cataract and Refractive Surgery
Volume40
Issue number4
DOIs
StatePublished - Jan 1 2014

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Phacoemulsification
Cataract Extraction
Anterior Chamber
Gonioscopy
Corneal Edema
Intraocular Lens Implantation
Disclosure
Iris
Capsules
Steroids
Head
Inflammation
Equipment and Supplies
Therapeutics

Cite this

@article{179512d118b4469b9c51ffea938cfecc,
title = "Delayed presentation of retained nuclear fragment following phacoemulsification cataract extraction",
abstract = "An 87-year-old woman presented 11 months after routine phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her left eye complaining of the abrupt onset of redness and decreased vision in that eye. Examination revealed a mild anterior chamber reaction and significant corneal edema. The eye was minimally responsive to topical steroid therapy, and initial serial slitlamp examinations with gonioscopy were unrevealing. After multiple head-positioning maneuvers were performed, a retained nuclear fragment was uncovered. The nuclear fragment was aspirated and liquefied by the phacoemulsification device in the anterior chamber. A retained nuclear fragment with an intact posterior capsule is a recognized cause of inflammation in the immediate postoperative presentation. Delayed presentation of symptoms is rare and presumably secondary to sequestration of the fragment behind the iris. We present a case and a review of the literature regarding sequestered retained nuclear fragments following what is initially thought to be uneventful cataract extraction. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.",
author = "Ali Mokhtarzadeh and Kaufman, {Stephen C.} and Dara Koozekanani and Alessandro Meduri",
year = "2014",
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doi = "10.1016/j.jcrs.2014.02.013",
language = "English (US)",
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journal = "Journal of Cataract and Refractive Surgery",
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TY - JOUR

T1 - Delayed presentation of retained nuclear fragment following phacoemulsification cataract extraction

AU - Mokhtarzadeh, Ali

AU - Kaufman, Stephen C.

AU - Koozekanani, Dara

AU - Meduri, Alessandro

PY - 2014/1/1

Y1 - 2014/1/1

N2 - An 87-year-old woman presented 11 months after routine phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her left eye complaining of the abrupt onset of redness and decreased vision in that eye. Examination revealed a mild anterior chamber reaction and significant corneal edema. The eye was minimally responsive to topical steroid therapy, and initial serial slitlamp examinations with gonioscopy were unrevealing. After multiple head-positioning maneuvers were performed, a retained nuclear fragment was uncovered. The nuclear fragment was aspirated and liquefied by the phacoemulsification device in the anterior chamber. A retained nuclear fragment with an intact posterior capsule is a recognized cause of inflammation in the immediate postoperative presentation. Delayed presentation of symptoms is rare and presumably secondary to sequestration of the fragment behind the iris. We present a case and a review of the literature regarding sequestered retained nuclear fragments following what is initially thought to be uneventful cataract extraction. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

AB - An 87-year-old woman presented 11 months after routine phacoemulsification cataract extraction and posterior chamber intraocular lens implantation in her left eye complaining of the abrupt onset of redness and decreased vision in that eye. Examination revealed a mild anterior chamber reaction and significant corneal edema. The eye was minimally responsive to topical steroid therapy, and initial serial slitlamp examinations with gonioscopy were unrevealing. After multiple head-positioning maneuvers were performed, a retained nuclear fragment was uncovered. The nuclear fragment was aspirated and liquefied by the phacoemulsification device in the anterior chamber. A retained nuclear fragment with an intact posterior capsule is a recognized cause of inflammation in the immediate postoperative presentation. Delayed presentation of symptoms is rare and presumably secondary to sequestration of the fragment behind the iris. We present a case and a review of the literature regarding sequestered retained nuclear fragments following what is initially thought to be uneventful cataract extraction. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

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