Retained lens fragment causing anterior uveitis four years after successful phacoemulsification

Abstract

Listen

Translate article

Introduction: Existing literature has detailed occurrences of retained cataract lens fragments identified days to weeks after cataract surgery. However, lens fragments in the anterior chamber remaining asymptomatic for several years are extremely rare, thus remaining a diagnostic challenge. A complex case of a retained lens fragment causing anterior uveitis 4 years after phacoemulsification is presented. Patient and Clinical Findings: A 76-year-old woman presented with a chief concern of right eye pain, photosensitivity, and blurred vision after head trauma. Diagnosis, Intervention, and Outcomes: Diagnostic imaging ruled out the presence of orbital fracture or globe deformity leading to an initial diagnosis of traumatic iritis. Initial management with topical corticosteroids did not improve symptoms. Subsequent slit lamp examination revealed a small cataract lens fragment in the anterior chamber leading to a diagnosis of anterior uveitis secondary to the retained lens. Anterior chamber washout was performed with successful removal of the fragment, and the patient reported resolution of pain and photosensitivity postoperatively. Conclusions: Owing to its rarity, diagnostic and treatment standards for retained cataract lens fragments have not yet been sufficiently explored. This case suggests that head trauma may be a precipitating event causing delayed onset of symptoms. Cataract lens retention should be considered in patients presenting with uveitis years after cataract surgery.