Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification
Purpose: To report a case of late onset corneal decompensation following cataract surgery due to retained lens fragment in anterior chamber. Observations: A 65 year old female presented with complaint of gradual dimness of vision in left eye since 4 months. She underwent uneventful phacoemulsificati...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-03-01
|
| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622000494 |
| _version_ | 1818974809626771456 |
|---|---|
| author | Abhay Vasavada Rinal Pandit Vandana Nath Shail Vasavada Vaishali Vasavada |
| author_facet | Abhay Vasavada Rinal Pandit Vandana Nath Shail Vasavada Vaishali Vasavada |
| author_sort | Abhay Vasavada |
| collection | DOAJ |
| description | Purpose: To report a case of late onset corneal decompensation following cataract surgery due to retained lens fragment in anterior chamber. Observations: A 65 year old female presented with complaint of gradual dimness of vision in left eye since 4 months. She underwent uneventful phacoemulsification with posterior chamber intraocular lens implantation elsewhere 4 years back. On examination, the CDVA in left eye was 20/200. Slit-lamp examination revealed corneal edema with Descemet's folds. She was diagnosed as pseudophakic bullous keratopathy and was being treated with topical steroids, cycloplegics and hyperosmolar agents for the same. She was also counseled about a lamellar corneal transplant. Posterior segment examination was within normal limits. Since the position of the IOL (sulcus versus bag) was not clearly seen ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) imaging was performed to try and better understand the possible cause for corneal decompensation. To our surprise, on both, UBM and ASOCT, a single, retained lens fragment was noted at 6 0'clock in the anterior chamber. AC wash was performed to remove the retained lens fragment. 3 months post AC wash corneal edema resolved completely with improvement in the BCVA to 20/40. Conclusion: AND IMPORTANCE: This case highlights the importance of a thorough clinical evaluation supplemented with imaging modalities in order to make a complete diagnosis and eventually achieve better outcomes for the patient. In any case of unexplained corneal edema, either in the early or late postoperative period, UBM and ASOCT can become very helpful to determine the underlying cause. |
| first_indexed | 2024-12-20T15:45:58Z |
| format | Article |
| id | doaj.art-d0911567cfd945b088669738d9a89211 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-20T15:45:58Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-d0911567cfd945b088669738d9a892112022-12-21T19:34:58ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-03-0125101303Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsificationAbhay Vasavada0Rinal Pandit1Vandana Nath2Shail Vasavada3Vaishali Vasavada4Raghudeep Eye Hospital, Nr. Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, 380052, Gujarat, India; Corresponding author.Department of Glaucoma, Raghudeep Eye Hospital, Nr. Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, 380052, Gujarat, IndiaDepartment of Cornea, Raghudeep Eye Hospital, Nr. Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, 380052, Gujarat, IndiaDepartment of Cataract and Refractive Services, Raghudeep Eye Hospital, Nr. Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, 380052, Gujarat, IndiaDepartment of Cataract and Refractive Services, Raghudeep Eye Hospital, Nr. Shreeji Complex, Gurukul Road, Memnagar, Ahmedabad, 380052, Gujarat, IndiaPurpose: To report a case of late onset corneal decompensation following cataract surgery due to retained lens fragment in anterior chamber. Observations: A 65 year old female presented with complaint of gradual dimness of vision in left eye since 4 months. She underwent uneventful phacoemulsification with posterior chamber intraocular lens implantation elsewhere 4 years back. On examination, the CDVA in left eye was 20/200. Slit-lamp examination revealed corneal edema with Descemet's folds. She was diagnosed as pseudophakic bullous keratopathy and was being treated with topical steroids, cycloplegics and hyperosmolar agents for the same. She was also counseled about a lamellar corneal transplant. Posterior segment examination was within normal limits. Since the position of the IOL (sulcus versus bag) was not clearly seen ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) imaging was performed to try and better understand the possible cause for corneal decompensation. To our surprise, on both, UBM and ASOCT, a single, retained lens fragment was noted at 6 0'clock in the anterior chamber. AC wash was performed to remove the retained lens fragment. 3 months post AC wash corneal edema resolved completely with improvement in the BCVA to 20/40. Conclusion: AND IMPORTANCE: This case highlights the importance of a thorough clinical evaluation supplemented with imaging modalities in order to make a complete diagnosis and eventually achieve better outcomes for the patient. In any case of unexplained corneal edema, either in the early or late postoperative period, UBM and ASOCT can become very helpful to determine the underlying cause.http://www.sciencedirect.com/science/article/pii/S2451993622000494UBMRetained lens fragmentPhacoemulsification |
| spellingShingle | Abhay Vasavada Rinal Pandit Vandana Nath Shail Vasavada Vaishali Vasavada Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification American Journal of Ophthalmology Case Reports UBM Retained lens fragment Phacoemulsification |
| title | Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| title_full | Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| title_fullStr | Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| title_full_unstemmed | Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| title_short | Late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| title_sort | late onset corneal decompensation following retained lens fragment in anterior chamber years after uneventful phacoemulsification |
| topic | UBM Retained lens fragment Phacoemulsification |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622000494 |
| work_keys_str_mv | AT abhayvasavada lateonsetcornealdecompensationfollowingretainedlensfragmentinanteriorchamberyearsafteruneventfulphacoemulsification AT rinalpandit lateonsetcornealdecompensationfollowingretainedlensfragmentinanteriorchamberyearsafteruneventfulphacoemulsification AT vandananath lateonsetcornealdecompensationfollowingretainedlensfragmentinanteriorchamberyearsafteruneventfulphacoemulsification AT shailvasavada lateonsetcornealdecompensationfollowingretainedlensfragmentinanteriorchamberyearsafteruneventfulphacoemulsification AT vaishalivasavada lateonsetcornealdecompensationfollowingretainedlensfragmentinanteriorchamberyearsafteruneventfulphacoemulsification |