Degree Of Corneal Edema Research Articles

The efficacy of tobramycin dexamethasone combined with pranoprofen in middle-aged and elderly post-cataract patients and the value of improving inflammatory factor levels.

To analyze the effect of tobramycin dexamethasone combined with pranoprofen on middle-aged and elderly patients after cataract surgery. In this retrospective study, the clinical data from 108 middle-aged and elderly patients who had cataract surgery in the Second Hospital of Longyan between January 2021 and December 2023 were collected. The patients were divided into two groups based on treatment methods, a control group (n=54) that received tobramycin dexamethasone treatment, and an observation group (n=54) that treated with additional pranoprofen. The treatment effects in the two groups were compared. Significant differences were observed between the groups at 1 day, 1 week, 3 weeks, and 5 weeks post-treatment in terms of ocular symptom scores, signs scores, and intraocular pressure levels (all P < 0.05). The observation group demonstrated lower levels of inflammatory markers post-treatment (P < 0.05). Additionally, at 1 week, 3 weeks and 5 weeks after treatment, significant differences were noted in anterior chamber flare value, best-corrected visual acuity (BCVA), macular center thickness, degree of corneal edema, and posterior lens capsular opacity grading scores (all P < 0.05). The incidence of increased intraocular pressure and conjunctival congestion was 3.7% in the observation group, slightly lower than 7.41% in the control group (P > 0.05). The combination of pranoprofen and tobramycin dexamethasone can improve the inflammatory reaction, ocular symptoms, anterior chamber flare value, macular center thickness, corneal oedema, and clarity of the posterior lens capsule in middle-aged and elderly cataract patients. This regimen also helps restore intraocular pressure and visual acuity of the patients, with relatively low adverse reactions, indicating an ideal clinical outcome.

Comparison of pre-chop technique using a reverse chopper and classic stop-and-chop technique in the treatment of high myopia associated with nuclear cataract

BackgroundTo evaluate the safety and efficacy of the pre-chop technique using a novel reverse chopper vs. the classic stop-and-chop technique in phacoemulsification for patients with high myopia and associated grade III–IV nuclear cataracts.MethodsIn this prospective cohort study, a total of 44 consecutive patients (44 eyes) with grade III–IV nuclear cataracts who were admitted to our hospital for cataract surgery between March 2018 and September 2018 were enrolled. All patients had ocular axial length > 27 mm and myopic refraction more than -10 diopters. Patients were randomly divided into a pre-chop group and stop-and-chop group using a randomization table. Nucleus splitting was performed surgically in both groups using either the pre-chop technique with reverse chopper or the classic stop-and-chop technique.ResultsPostoperative visual acuity was significantly improved in both groups compared with preoperative values. Significantly better visual acuity, lower degree of corneal edema and lower rates of corneal endothelial cell loss were observed in the pre-chop group compared to those in the classic stop-and-chop group. No complications were reported in either group.ConclusionsIn treating patients with high myopia associated with grade III–IV cataracts, the pre-chop technique using a reverse chopper reduces damage to corneal endothelial cells and improves visual acuity better than the classic stop-and-chop technique.

Application of vertical chop combined with horizontal chop in hard nuclear cataract surgery

Objective To evaluate the efficacy of vertical chop combined with horizontal chop in hard nuclear cataract surgery. Methods A retrospective study. Total of 86 eyes of 86 patients with senile cataract were randomly divided into two groups, and all nuclear classification ranged from IV to V. Group A, 43 patients, received vertical chop combined with horizontal chop. Group B, 43 patients, received phacoemulsification with high vacuum splitting. The efficacy were compared between the two groups. Results The ultrasonic time (UST) was (67.77±14.68) s of group A and (103.09±44.89) s of group. The cumulative dissipated energy (CDE) was 35.33±12.75 of group A and 41.25±14.35 in group B. The difference in UST and CDE were significant statistically between the two groups (P 0.3 occupied 86.05 % in group A and 67.44 % in group B (P=0.04). The corneal edema at 1 day postoperatively in group A was lower than that in group B, the difference was statistically significant between the two groups (P=0.03). The difference in degree of corneal edema at 7 days after surgery was not statistically significant between the two groups. The corneal endothelial cells (CECs) in 1 month postoperatively was (2 371.30±179.02)/mm2 in group A and (2 157.80±156.46)/mm2 in group B(P<0.01). The loss rate of CECs was (8.73±3.74)% in group A and (15.41±3.54)% in group B(P<0.01). Conclusion Application of vertical nuclear chop combined with horizontal nuclear chop in hard nuclear cataracts surgery is effective. Key words: Cataracts, hard nuclear; Chop, vertical; Chop, horizontal

The effectiveness and safety of topical 0.1% tacrolimus after high-risk penetrating keratoplasty

Objective: To observe the effectiveness and safety of topical 0.1% tacrolimus(FK506) as immunosuppressant in high-risk penetrating corneal transplantation to prevent the immune rejection and to compare the outcomes with topical 1% Cyclosporin A (CsA). Methods: The study consists of 49 patients (50 eyes), who were fitted with the high-risk corneal transplantation standard and undergone the penetrating keratoplasty(PKP) or combined operation in Beijing Tongren hospital between March 2015 to September. With the time sequence, the patients were divided into observation group (FK506 group) and the control group (CsA group). The observation group included 9 females and 16 males with an average age of 57.8±14.8. Twenty-four patients were in the control group (25 eyes), including 10 females and 14 males, with an average age of (45.1±16.2). Observation group was treated with topical 0.1% tacrolimus, and the control group treated with topical 1%CsA. Both groups' treatment combined glucocorticoid as well. Two groups had 1 year follow-up observation. The incidence of rejection was compared by statistical methods of Cox regression. The adverse reactions were graded and compared using Mann-Whitney U test. Results: After one year, 22 cases of the observation group and 23 cases of the control group were accomplished all observations. The rejection rate was 4.54% in observation group and 27.23% in control group. The difference between the groups was statistically significant (χ(2)=4.291, P=0.038). Control group had high rejection rate. Besides, there was no severe side effects happened in both groups. After 1 month after surgery, 36.4% of the observation group showed mild corneal edema. The ratio of mild to moderate corneal edema in the control group was 26.1% and 8.7%. Three months after surgery, 4.5% of the observation group showed mild corneal edema, while 13.0% and 13.0% of the control group was found mild to moderate corneal edema. Six months after surgery, 4.5% of the observation group showed moderate corneal edema. The ratio of mild, moderate to severe corneal edema in the control group was 17.4%, 17.4% and 8.7%. The degree of corneal edema in the control group was more serious in three monthes(Z=-2.770, -2.018, -2.941, P<0.05). The differences in both monthes were statistically significant. Mild neovascularization occurred in the 13.6% of observation group. Mild to severe neovascularization occurred in the 13.0%, 4.3%, and 4.3% control groups. The degree of neovascularization in the control group was higher than that in the observation group(Z=-3.221, P=0.001). The differences in both months were statistically significant. Mild to moderate neovascularization occurred in the 18.2% and 9.1% of observation group. Mild to extremely severe neovascularization occurred in the 17.4%, 26.1%, 4.3% and 4.3% control groups. The degree of neovascularization in the control group was higher than that in the observation group(Z=-1.988, P=0.047).The differences in both monthes were statistically significant. Conclusions: Both 0.1% tacrolimus and 1% cyclosporine A are safe and effective in reducing the rejection after high-risk corneal transplantation. (Chin J Ophthalmol, 2019, 55: 419-427).

Early postoperative results of Descemet's stripping endothelial keratoplasty in six dogs with corneal endothelial dystrophy.

To describe and assess the clinical outcome and intraoperative and postoperative complications of Descemet's stripping endothelial keratoplasty (DSEK) in the treatment of canine corneal endothelial dystrophy. Six dogs (six eyes) diagnosed with progressive corneal edema resulting from abnormal dystrophic endothelial cells underwent Descemet's stripping endothelial keratoplasty. Six patients underwent Descemet's stripping endothelial keratoplasty (DSEK). The patients were examined preoperatively and postoperatively at 24hours, 7days, 1, 2, and 3months after surgery. Corneal edema and ultrasonic pachymetry were evaluated preoperatively and postoperatively. The positions of DSEK grafts were evaluated 3months after surgery using optical coherence tomography. Intraoperative and postoperative complications were noted. The degree of corneal edema and corneal thickness improved postoperatively in all the patients (n=6). Fibrin was encountered intraoperatively in one out of the six eyes (1/6) and postoperatively in two out of the six eyes (2/6). One out of the six DSEK grafts was partially scrolled (1/6). Secondary ocular hypertension was observed in one out of the six eyes (1/6). Corneal vascularization was encountered in four out of six patients (4/6). Descemet's stripping endothelial keratoplasty is an effective surgical treatment option for corneal endothelial dystrophy in dogs. Corneal edema resolved and corneal thickness reduced significantly. The early postoperative results are encouraging. Further investigation is warranted to document any long-term complications and to study the longevity of the transplanted grafts.

Observation on the efficacy and characteristic of 203 cataract patients in Brightness Action, Morocco

Objective To observe the clinical efficacy and characteristic of 203 cataract patients in Brightness Action, Morocco. Methods Total 203 eyes of 203 cases of cataract underwent phacoemulsification combined with intraocular lens implantation by Chinese-Africa Action Expert Group in Morocco from Oct.8th, 2016 to Oct. 10th.The postoperative visual acuity, characteristic of lens opacity and complications were analyzed. Results The patients were followed up for 1-3 months. One week after operation, the visual acuity was <0.05 in 7 eyes (3.4%), 0.05-0.25 in 30 eyes (14.8%), 0.3-0.5 in 123 eyes (60.1%), ≥0.6 in 43 eyes (21.2%). The rate out of blindness was 96.55%.During operation pseudoexfoliation syndrome occurred in 29 eyes and among them 16 eyes received radiate scissors of the sphincter of pupil.Posterior capsular rupture occurred in 6 cases, among them 2 cases received anterior vitrectomy combined with implantation of three piece IOL, 1 case changed to extracapsular surgery without IOL implantation. Four cases of high myopia were operated without IOL implantation due to lens degree insufficiency .One case with iris prolapse caused by high intraocular pressure was continued normal operation after 5 minutes. The postoperative complications included varying degrees of corneal edema 1 day after operation in 46 eyes, poor closure of incision and leakage of aqueous humor in 1 eye, high intraocular pressure in 1 eye, residual cortex in 2 eyes, surviving anterior vitreous body in 2 eyes, vitreous traction pupil in 1 eye, 1 eye of nasal minor vitreous hemorrhage and 1 eye of anterior uveitis. Three months after operation, no endophthalmitis, bullous keratopathy or secondary glaucoma happened. Conclusion The phacoemulsification combined with intraocular lens implantation in Brightness Action, Morocco can achieve good postoperative results, safe and reliable. Key words: Cataract; Phacoemulsification; Brightness Action, Morocco

Evaluation of factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty.

To elucidate the factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK). We reviewed consecutive patients who underwent primary DSAEK for corneal endothelial dysfunction at Inouye Eye Hospital from January 2010 through January 2015 and who had a follow-up of at least 6months. Fifty-four eyes of 49 patients (24 men and 25 women) were enrolled; the mean age was 72.5±8.7years. Medical charts were retrospectively examined for best spectacle-corrected visual acuity (BSCVA), intraocular pressure, keratometric value, keratometric cylinder, grade of preoperative corneal edema, preoperative graft thickness, and endothelial cell density (ECD) before and at 1, 3, 6, 12, and 24months after surgery. A multiple regression analysis was used to evaluate the factors associated with BSCVA at 3, 6months, and 1year after surgery. Explanatory variables included age, sex, preoperative factors (BSCVA, degree of corneal edema, donor ECD, and graft thickness), and factors at each time point (keratometric value, keratometric cylinder, and intraocular pressure). The mean logarithms of the minimum angle of resolution (logMAR) BSCVA preoperatively and at 1, 3, 6, and 12months after surgery were 1.03±0.49, 0.42±0.26, 0.29±0.21, 0.24±0.20, and 0.22±0.20, respectively. Multiple regression analysis showed that preoperative BSCVA alone was significantly associated with BSCVA at 3, 6, and 12months. A better preoperative BSCVA was associated with a better BSCVA after DSAEK, which suggests that DSAEK should be considered earlier than stromal changes such as subepithelial fibrosis occurrence.

A comparative study between reverse chopper-assisted prechop phacoemulsification and stop-and-chop phacoemulsification for cataract with IV degree hard nucleus

Background The pre-chop technique can decrease the use of ultrasound power, and thus reducing the loss of corneal endothelial cells (CECs) and injuries of other intraocular structures.Many currently developed manual pre-chop techniques restrict the wide application of the pre-chop technique because of their intrinsic disadvantages.The present study describes a manual pre-chop technique for pre-slicing the lens nucleus by using a novel reverse chopper, which has not been reported yet. Objective This study was to compare the efficacy and safety of pre-chop technique using a reverse chopper and stop-and-chop phacoemulsification technique on Ⅳ degree hard nucleus cataract. Methods A prospective clinical-controlled interventional study was performed.Thirty-two eyes of 32 cataract patients with Ⅳ degree of nucles were enrolled in People's Hospital of Hetian District from March 2015 to January 2016.The patients were randomized into the prechop group and matched stop-and-chop group according to random number table.The self-made reverse chopper-assisted pre-chop phacoemulsification surgery and stop-and-chop phaco surgery were performed on the eyes of corresponding groups, respectively.The ultrasound power, effective phaco duration, corneal endothelium loss rate, the eye number of different grade of cornea edema after operation and vision outcome were compared between the two groups.Written informed consent was obtained prior to relevant examination and surgery. Results The mean effective Phaco durations were 42.56 (39.31, 45.81) seconds and 78.63 (73.85, 83.40) seconds in the prechop group and stop-and-chop group, with a significant difference between them (Z=-4.937, P=0.000). The eye number with different degree of best corrected visual acuity (BCVA) was significantly different between the two groups, at postoperative day 1 and day 3 (P=0.013, 0.033). The number of corneal endothelial cells (CECs) 1 month after surgery was (2 026.05±154.03)/mm2 in the prechop group, and the number was (1 866.50±117.16)/mm2 in the stop-and-chop group, with a significant difference between them (t=3.298, P=0.003). The CECs loss rate was (13.36±2.85) % in the prechop group, which was lower than (25.77±3.81) % in the stop-and-chop group (t=-6.996, P=0.000). The eye number with different degree of corneal edema was significantly decreased in the prechop group compared with the stop-and-chop group at postoperative day 1 and day 3 (P=0.001, 0.002). Conclusions Compared with the stop-and-chop phaco technique, a reverse chopper-assisted pre-chopping technique can decrease the intraoperative complication, lighten the postoperative damage of CECs and accelerate visual rehabilitation in hard nucleus cataract eyes. Key words: Cataract/surgery; Phacoemulsification/methods; Lens nucleus, crystalline/surgery; Treatment outcome; Comparative study; Pre-chopping technique; Stop-and-chop technique; A reverse chopper; Humans

콘택트렌즈의 재질별 각막부종의 비교

Purpose: This study has been compared the degree of corneal edema arising from the material of the lens after wearing the recommended wearing time for the contact lens. Methods: For the study, 43 adults of 77 eyes who did not use drugs and have not any disease participated. Three types of lenses including narafilcon A, HEMA, and silicone hydrogel material regular replaceable lenses were used. Central corneal thickness was measured before and after 8 hours from wearing lenses using Pentacam. The degree of corneal edema was determined by the difference before and after wearing. Results: The average corneal edema of narafilcon A, HEMA material lens, and silicone hydrogel material regular replaceable lens were , , , respectively. The central corneal thickness after wearing narafilcon A was not statistically significant with the central corneal thickness before wearing the lens. Central corneal thickness before and after wearing HEMA material lens and silicone hydrogel material regular replaceable lens were statistically significant. Conclusions: The amount of corneal edema induced by silicone hydrogel material regular replaceable lens was no statistically significant difference to the amount of corneal edema induced by HEMA material lens, but there was significant difference to narafilcon A. Therefore, it is judged to be careful not to exceed the recommended wearing time depending on the composition of the contact lens material.

Characteristics and effects of surgery treatment for complicated cataract in silicone oil filled eyes

Objective To analyze the characteristics of complicated cataract of silicone oil tamponade eyes after pars plana vitrectomy, and to evaluate the effects of phacoemulsification and its relative factors. Methods Data of 51 eyes of 47 patients who underwent the treatment of phacoemusification for complicated cataract after silicone oil tamponade were analyzed. Twenty-eight patients were males (28 eyes), and 19 were females (23 eyes). The average age was (55.45±11.37) years old with a range from 22 to 75 years old. The protopathy of all patients with silicon oil tamponade eyes included rhegmatogenous retinal detachment in 11 patients (11 eyes), macular hole induced by high myopia in 3 patients (3 eyes), PDR in 27 patients (31 eyes), retinal vein occlusion in 4 patients (4 eyes), and penetrating ocular injury in 2 patients (2 eyes). The preoperative best corrected visual acuity (BCVA) ranged from light perception to 0.25. The preoperative intraocular pressure (IOP) was (16.87±5.29) mmHg (13.0~41.0 mmHg). The corneal endothelial cell counts was (2632.8±402.9)/mm2 (845~3448/mm2). The follow-up was (4.71±1.12) months with a range from 3 to 6 months. Results The lens in silicon oil tamponade eyes was characterized by nuclear opacity with little posterior cortex adhered tightly to the posterior capsule. The postoperative BCVA ranged from light perception to 0.6. BCVA increased in 47 eyes, remained stable in 3 eyes, and decreased in 1 eye. The postoperative IOP was (14.82±2.56) mmHg with a range from 11.0 to 24.0 mmHg (1 mmHg=0.133 kPa), and decreased compared with preoperative one (P<0.05). The postoperative corneal endothelial cell counts was (1926.89±449.91)/mm2 (608~2850/mm2), and decreased compared with preoperative one (P<0.05). The intraoperative and postoperative complications mainly included posterior capsule rupture (1 eye), temporary IOP elevation (5 eyes), various degrees of corneal edema (all 51 eyes), various degrees of aqueous flare (29 eyes), anterior chamber blood cells (1 eye), and papillary zone fibrin exudation (1 eye). Conclusion Complicated cataract of silicone oil tamponade eyes is characterized by nuclear opacity with little posterior cortex adhered tightly to the posterior capsule. Higher vacuum and lower energy should be highlighted in phacoemulsification surgery, and it should be a caution to protect the posterior capsule. Phacoemulsification is a safe and effective method for the treatment of complicated cataract in silicone oil tamponade eyes. Key words: Silicon oil; Cataract, complicated; Phacoemulsification

Femtosecond Laser (WaveLight FS200) Customized Keratoplasty for Keratoconus: Case Report

To describe a case of a 52-year-old man with severe keratoconus who underwent femtosecond laser-assisted keratoplasty with the WaveLight FS200 femtosecond laser (Alcon Laboratories Inc). The donor and recipient corneas were cut in a mushroom-shaped pattern. The laser parameters used on this platform for the donor and recipient corneas are described. Corrected distance visual acuity improved by 3 weeks postoperatively. Mean keratometry decreased from 60.00 to 46.00 diopters. This patient underwent a mushroom-shaped keratoplasty with the femtosecond laser to maximize preservation of his own endothelium. Increased energy and/or decreased spot line separation may be required depending on the degree of corneal edema or scarring involved.

LMWH inhibits anterior chamber inflammation after extra capsular lens extraction through down regulation of bFGF content in aqueous humor.

To observe the changes of basic fibroblast growth factor (bFGF) content in anterior chamber before and after extra capsular lens extraction for investigating the mechanism of low molecular weight heparin (LMWH) inhibiting anterior chamber inflammation. Eighty-four rabbits were randomly divided into control and experimental group, 42 rabbits in each group. Extra capsular lens extraction was done on unilateral eye in each rabbit. LMWH was perfused into anterior chamber by the concentration of 50U/mL at the end of operation in experimental group. The degrees of corneal edema, aqueous flare and fibrin were evaluated with slit lamp microscope on postoperative day 1, 3, 6, 15, 30, 45 and 60, respectively. Six eyes of each group were at each time point. Contents of bFGF in aqueous humor were determined by ELISA after animals were killed. Another six eyes were used for determining the base line level of bFGF in aqueous humor. The degrees of corneal edema, aqueous flare and fibrin in experimental group were significantly lighter than those in control group (P<0.01) on postoperative day 1, 3 and 6, respectively. No difference was showed between the two groups at other point time. Contents of bFGF in aqueous humor increased at the same time. bFGF content reached peak on postoperative day 1 in experimental group, while on postoperative day 6 in control group. Contents of bFGF in the two groups declined slowly after reaching peak. The bFGF content in control group were significantly higher than that in experimental group 1-30 days after surgery (P<0.05). No significant differences were shown between the two groups on postoperative day 45 and 60, respectively. Perfusion with LMWH by the concentration of 50U/mL can significantly reduce anterior chamber inflammation after extra capsular lens extraction in rabbits, which may be related to down regulation of bFGF content in aqueous humor.

Clinical ocular findings in cows with malignant catarrhal fever: ocular disease progression and outcome in 25 cases (2007–2010)

To describe the ocular clinical signs in a group of cows diagnosed with sheep associated malignant catarrhal fever (MCF), and to investigate a possible correlation between the severity and progression of certain typical clinical signs and disease outcome. This prospective study involved cows diagnosed with MCF between 2007 and 2010, and included cows enrolled in a larger clinical trial. Signalment of affected cows, presence and progression of ocular lesions, as well as disease outcome were recorded. Cows were divided into two groups based on the disease outcome: (1) survival and (2) nonsurvival. The degree of corneal edema at first examination was statistically compared between groups. The progression of corneal edema, uveitis and the examining ophthalmologists' subjective assessment of disease progression between the first and last examination were also compared between groups. Twenty-five cows (22 F, 3 M) of six different breeds and one mixed breed were included. Median age was 21 months (range 8-113). Ten cows survived, 13 cows were euthanized, and two died. No statistical association was identified between the degree of corneal edema at the first examination and the disease outcome. Deterioration of corneal edema was not noticed in any of the surviving animals. Anterior uveitis improved in all 10 surviving cows. The degree of corneal edema at first examination had no prognostic value for the disease outcome. The results of this study suggest that the progression of corneal edema correlates well with disease outcome, and that nonimprovement of uveitis is a bad prognostic sign.

Torsional mode phacoemulsification: Effective, safe cataract surgery technique of the future

Purpose:To compare various outcome measures using torsional mode and longitudinal mode in the phacoemulsification of cataract with different nuclear densities.Setting: Magrabi Eye Hospitals, Kingdom of Saudi Arabia.Design: A randomized comparative clinical study.Materials and Methods:This study includes 200 eyes of 156 patients (100 in the ultrasound longitudinal “US” group and 100 in the torsional group). All eyes received AcrySof® single piece intraocular lens (Alcon Surgical, Fort Worth, TX). The primary outcome measures were ultrasound time (UST), cumulative dissipated energy (CDE), and surgical complications. Postoperative outcome measures were the degree of corneal edema on the first postoperative day and final best corrected visual acuity (BCVA) and CCT (central corneal thickness).Results:The differences in UST and CDE between subgroups of nucleus hardness were statistically significant (P < 0.01). The UST and CDE consistently increased in eyes with higher grades of nucleus density. On day one, the mean BCVA was 0.61 ± 0.13 decimals in the ultrasound (US) group and 0.67 ± 0.11 decimals in the torsional group (significant P < 0.05). Corneal edema was significantly less in the torsional group (P < 0.05). At 30 days, the mean BCVA was 0.94 ± 0.22 decimals in the US group and 1.0 ± 0.12 decimals in the torsional group but this difference was not statistically different (P > 0.05).Conclusions:The torsional mode provides an effective and safe method for cataract removal with lower energy usage as compared to longitudinal traditional phacoemulsification. However, the final visual outcome was similar for both study groups.

Management of retained lens fragments after cataract surgery with and without pars plana vitrectomy

To compare the clinical course of patients with retained lens particles after phacoemulsification who had early or late pars plana vitrectomy (PPV) and removal of retained lens fragments or who were managed medically. Private practice and University of Louisville, School of Medicine, Louisville, Kentucky, USA. This retrospective review comprised patients who had cataract fragments dislocated into the vitreous during attempted cataract extraction and intraocular lens implantation over an 8-year period. Patients were divided into 3 groups. The early surgery group was treated with PPV and removal of lens fragments within 1 week of cataract surgery. The late surgery group had PPV more than 2 weeks after cataract surgery. The medical therapy group was managed with topical and systemic medications alone. The visual acuity, degree of corneal edema, inflammation, and intraocular pressure (IOP) were measured. Postoperative follow-up was at 7, 14, and 30 days and 1 year. The study evaluated 42 patients (12 early surgery, 15 late surgery, and 15 medical therapy). Demographic characteristics, visual acuity, and mean IOP values at presentation were similar between the 3 groups. Visual acuity was not statistically significantly different between groups at 30 days and 1 year. There was no statistically significant difference in IOP between groups throughout the study period. Retained lens fragments were managed conservatively with good visual results. Vitrectomy was effective in patients with retained lens fragments not responding to topical and oral medication. Results indicate that surgery can be successfully delayed in certain patients.