Posters

Extracapsular extraction of hypermature dislocated cataractous lens and liquefied retrocapsular lens cortex material by an anterior segment surgeon

Poster Details

First Author: S.Moutzouri GREECE

Co Author(s):    A. Diafas   N. Xanthopoulou   P. Kazantzidou   I. Chalkias   E. Chalkias   D. Stampouli     

Abstract Details

Purpose:

To present an interesting case of a woman with hypermature cataract and liquefied lens cortex material located behind the posterior capsule which was discovered accidentally during cataract surgery.

Setting:

Department of Ophthalmology, General Hospital of Xanthi, Xanthi, Greece

Methods:

An 82-year woman was referred to our department for cataract surgery of her right eye (OD) due to progressively deteriorating vision over several months. She had a history of uncomplicated cataract surgery in her left eye (OS) two years ago. At examination she had best corrected visual acuity (BCVA) hand motion (OD) and 6/10 (OS). Intraocular pressure was 11mmHg bilaterally on treatment with latanoprost. Slit lamp examination revealed an hypermature white cataract (OD). Anterior segment was normal without signs of inflammation. Dilated fundus examination (OD) was impossible due to the lens opacification. The patient was scheduled for extracapsular cataract extraction.

Results:

After successful removal of the nucleus through a 6mm scleral tunnel and irrigation/aspiration of the remaining cortex material were performed, a milky opacification was noticed, located behind of the posterior capsule. A three-pieces intraocular lens (IOL) was inserted in the bag and the frown-shaped scleral incision was sutured. The liquefied cortical material was successfully removed with anterior vitrectomy. The IOL was placed in the sulcus. No vitreous loss occurred. The paracentesis incisions were closed by stromal hydration and the conjunctival wound was closed using cautery. At the follow-up one month later BCVA was 7/10 (OD) without any sign of inflammation.

Conclusions:

Hypermature cataracts are related to a variety of complications thus both doctors and patients should not postpone the cataract surgery until the lens is totally opacified. The presence of liquefied cortical material behind the posterior capsule is a rare entity. It usually occurs in patients with phacolytic glaucoma with elevated IOP and signs of inflammation in the anterior segment. A thorough evaluation of the patient preoperatively as well as alertness to deal with any intraoperative complications are of utmost importance.

Financial Disclosure:

None