Risk factors, complications, and outcomes of phacoemulsification cataract surgery complicated by retained lens fragments in Asian eyes: A 10-year retrospective study.

PURPOSE

To study the risk factors, visual outcomes, and sequelae of phacoemulsification surgery complicated by retained lens fragments (RLFs).

METHODS

This single-center case-control study enrolled consecutive eyes complicated by RLF and compared them to age- and gender-matched uneventful cataract surgery cases at a tertiary care teaching hospital. Biometric, intraoperative, and postoperative data were collected. The primary outcome measures were risk factors, visual outcomes, and rate of postoperative complications.

RESULTS

The study and control groups included 282 and 289 eyes, respectively. The estimated incidence of RLF was 1.47% during the study. We found a statistically higher risk of RLF among diabetics ( < 0.001), those with a history of intravitreal injections ( = 0.001), eyes with dense nuclear sclerosis, anterior capsular cataract ( < 0.001), and posterior polar cataract ( = 0.01). There was a statistically higher risk of RLF in eyes with a higher mean preoperative visual acuity (logarithm of the minimum angle of resolution) ( < 0.001) and in cases performed by trainees ( < 0.001). Most eyes in the RLF group ( = 207, 73.4%) retained their preoperative vision or experienced a one-line improvement in visual acuity and 14 eyes (5.3%) experienced more than one-line improvement in vision.

CONCLUSION

Although RLFs are rare, they can affect the quality of postoperative vision and outcomes of complicated phacoemulsification surgery.