Dropped lens fragments in cataract surgery leads to worse visual outcomes

Worse visual outcomes and higher chances of postoperative cystoid macular edema (CME), rhegmatogenous retinal detachment (RRD), and epiretinal membrane (ERM) were found in eyes undergoing phacoemulsification that experienced posterior capsule rupture (PCR) and dropped lens fragments (DLF) compared to eyes that had uneventful surgery, according to a study.

In a retrospective comparative non-randomized study, data from 2751 eyes that experienced PCR, 519 eyes that experienced DLF, and 175,589 eyes in a reference group were collected.

The mean visual acuity (VA) in the DLF and PCR groups was significantly worse than the reference group at all postoperative intervals analyzed. At 4-12 weeks postop, the odds of having a VA ≤ 0.3 logMAR were 88% and 73% lower than the reference group in eyes with DLF and PCR, respectively. Cystoid macular edema was more likely to develop in both groups compared with the reference group.

There were 3.6 and 1.8 times higher odds of needing RRD surgery in the DLF and PCR groups, respectively; the odds of requiring ERM surgery were 2.1 and 1.3 times higher, respectively.

Reference
Foaud YA, Jabbehdari S, Neuhouser A, et al. Visual Outcomes and Postoperative Complications of Eyes with Dropped Lens Fragments During Cataract Surgery: A Multicenter Database Study. J Cataract Refract Surg. 2023;doi: 10.1097/j.jcrs.0000000000001137. Epub ahead of print. PMID: 36700943.