Retained Lens Material & Dislocated Intraocular Lens

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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