A seventy year-old woman had undergone cataract surgery twenty-four hours before. During the intraocular lens (IOL) implantation into the capsular bag, the posterior haptic was broken down remaining inside the injector. The anterior segment surgeon tried then to extract the IOL but during this maneuver it was accidentally luxated into the vitreous cavity through a posterior capsule rupture. At that point the surgeon performed an anterior vitrectomy to release the incarcerated vitreous. The following day the patient was referred to the retina department. During the fundus examination we observed the IOL luxation and a peripheral giant retinal tear.

Methods:

The employed technique consisted in: Vitrectomy, perfluorocarbon liquid insertion to protect the posterior pole and to attach the retina, completed section of the IOL inside the vitreous cavity to allow its extraction through the anterior capsulotomy, endophotocoagulation of the giant retinal tear, implantation of an intraocular lens into the sulcus and perfluorocarbon-gas exchange.

Take home message:

Cataract surgery can create severe retinal complications. Rapid action in these patients improves the prognosis.