Lens Loss and Dislocation
Retained Lens Material
During cataract surgery, it is possible for a portion of your natural lens
(the cataract), to fall into the back of the eye (vitreous cavity). This
can cause the intraocular pressure in the eye to rise or it may cause
inflammation. Vitrectomy may be necessary to remove the lens or lens fragments.
Small lens fragments falling into the vitreous cavity are not unusual
and many times do not require removal. These lens fragments occur when
the bag of the lens, called the capsule, breaks during cataract surgery
allowing for portions of the cataract in the bag to fall posteriorly.
It is safest for your doctor not to try to retrieve the particles as special
equipment is needed.
Dislocated Intraocular Lens
The dislocation of the artificial lens implant, the intraocular lens (IOL),
can also occur during or after cataract surgery. The IOL can shift from
its proper position or fall into the vitreous cavity. In this case, vitreous
surgery is needed to replace the IOL into its correct position. Depending
on individual cases, the vitreous is removed and the lens is repositioned
or sutured to keep it in place. In some cases the IOL may need to be replaced
with a new one entirely. The patient’s vision will generally improve
following the surgery.
The intraocular lens may dislocate because the small thread like supporting
structures called the zonules may be weak and not be able to support the
lens. They can be weakened from trauma, congenital defects or unknown
reasons. The capsule of the natural lens which is necessary to support
the artificial intraocular lens may also be weak, and the lens will not
stay in the proper position. There is a condition known as seudoexfoliation
that causes the zonules to weaken over a long period of time and the lens
may move or dislocate years later for no apparent reason.
In both cases, some floaters may be left, which usually decrease with time.
Immediately after surgery you will have blurred vision that will gradually
improve. You will need to be aware of any decrease in peripheral vision
such as cloud-like darkening in vision. Report any changes to your doctor,
as this may represent a retinal detachment. Any increase in pain, decrease
in vision, increase in floaters and light flashes should also be reported.
You will also receive drops to reduce the formation of a leakage in the
macula (center portion of our vision) known as cystoid edema.
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