This patient came to see us for a second opinion following cataract surgery elsewhere six weeks earlier. He has been on topical steroid drops since his surgery. His pressure was 42 mmHg with significant anterior chamber cell and flare.
Virtually the entire cataract was floating in the inferior vitreous. He was scheduled for immediate pars plana vitrectomy and lensectomy.
Learning Points:
Posteriorly dislocated lens fragments are a known complication of cataract surgery. The crystalline lens is an immunoprecipitated tissue.
When lens fragments are exposed after cataract surgery, severe inflammation and increased intraocular pressure usually follow. Rarely, permanent vision loss occurs from glaucoma or cystoid macular edema.
Small lens fragments can be managed conservatively, but larger fragments require surgical removal.
