Dislocated nuclear fragments after cataract surgery.

Posterior nuclear dislocation is a serious complication of cataract surgery, especially when using the phacoemulsification technique. So far, there have been only a few reports concerning the indications and timing of vitrectomy with nuclear removal as well as long-term visual outcome of these eyes. We analysed 23 consecutive patients (follow-up at least 3 months) with intravitreal nuclear remnants after cataract surgery treated with vitrectomy and removal of posteriorly dislocated nuclei. All the eyes had increased intraocular pressure pre-vitrectomy, 63% had corneal oedema, 67% marked uveitis and 26% either retinal tear or detachment. Vitrectomy was performed within 1 week in 70% of eyes. In 14 eyes (61%) the final visual acuity was 20/40 or more. The main reason for poor visual outcome was retinal detachment (9%). These results indicate that with vitrectomy and removal of the nucleus good visual results can be achieved in a large proportion of eyes with posterior dislocation of nuclear remnants.