This 83YO female underwent cataract extraction for a hypermature lens. The posterior capsule tore, and a large lens fragment fell posteriorly. A 3 piece intraocular lens was successfully placed in the sulcus at the time of surgery.
She had previously received multiple intravitreal injections from multiple outside providers for exudative macular degeneration. We have no documentation if the capsule had ever been compromised.
Learning Points:
Posteriorly dislocated lens fragments are a known complication of cataract surgery. The crystalline lens is an immune privileged tissue. When lens fragments get exposed following cataract surgery, severe inflammation and increased eye pressure usually follow.
Rarely, permanent vision loss occurs from glaucoma or cystoid macular edema. Small lens fragments can be managed conservatively, but larger fragments like this one need to be surgically removed.
