We specialize in the medical and surgical treatment and management of sight threatening diseases affecting the retina, vitreous and macula. We have years of experience in treating the following conditions.
- Age Related Macular Degeneration
- Central Serous Retinopathy/Chorioretinopathy
- Choroidal Melanoma
- Choroidal Nevus
- Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)
- Cystoid Macular Edema
- Diabetic Retinopathy
- Dislocated Intraocular Lens
- Flashes, Floaters and Posterior Vitreous Detachment
- High Blood Pressure and Your Retina
- Idiopathic Parafoveal Telangiectasia (PFT)
- Inherited and Genetic Retinal Diseases
- Intraocular Infections (Endophthalmitis)
- Intraocular Inflammation/Uveitis
- Ischemic Optic Neuropathy
- Macular Pucker/Epiretinal Membrane
- Macular Hole
- Ocular Histoplasmosis Syndrome
- Peripheral Retinal Pathology Including Lattice Degeneration, Retinoschisis, and Masses
- Retained Lens Fragments
- Retinal Artery Occlusion
- Retinal Detachment
- Retinal Tears
- Retinal Vein Occlusion
- Vitreomacular Traction Syndrome
Retained Lens Fragments
What are Retained Lens Fragments?
Retained Lens Fragments (RLFs) occur following cataract surgery. In most cases, cataract surgery is performed without complication. However, in some eyes (up to 1%), the cataract cannot be removed completely, and fragments of the cataract may fall into the back of the eye where they cannot be safely removed by a cataract surgeon. In these cases, additional surgery may need to be performed by a vitreoretinal surgeon who can safely retrieve the cataract fragments from the back of the eye.
Why do I have retained lens fragments?
There are many reasons why patients may be predisposed to retained lens fragments. Sometimes the cataract is very advanced and hard to remove in its entirety. In some cases, the "bag" that the cataract rests in or the zonules that hold it in place can become damaged and some pieces of the cataract lens can then float into the back of the eye.
What are some problems that retained lens fragments could cause?
Depending on the size and the type of the fragments, patients may experience adverse symptoms. When cataract pieces (or lens fragments) remain in the eye after surgery, a severe inflammatory reaction can occur that may cause high pressure in the eye, swelling in the center of the retina (macular edema) and cornea, and even potentially permanent visual loss. Additionally, vitreous hemorrhage, retinal tears, and/or retinal detachments may also occur.
How are retained lens fragments treated?
1) Observation: In many cases the fragments are small enough that they dissolve over time on their own. Your eye doctor may just observe these types of cases closely and monitor or treat any inflammation, intraocular pressure increase, or macular edema.
2) Medical treatment: Inflammation may be treated with anti-inflammatory eye drops. Intraocular pressure can be managed with anti-inflammatory and glaucoma drops. Macular edema can be treated with anti-inflammatory eye drops or with steroid injections around or into the eye.
3) Surgical treatment: If the retained lens fragments are large or dense and/or the inflammation, intraocular pressure, and edema cannot be controlled medically then surgical intervention may be necessary. A pars plana vitrectomy and lensectomy can be done to remove the residual lens fragments and usually leads to improved inflammation and intraocular pressure.