CatractComplication

Had cataract surgery.  Piece of natural lens left at 12:00 because of danger of tearing "membrane".  Drops to soften or "dissolve" piece.  Hoped would drop sideways but dropped straight down and now "stuck" mid-center resulting in whiteout.  Saw well day after when bandages removed.  Now waiting for piece to soften enough to go back in and "vacuum" out.  Have not found any reference to this condition online.  Told not uncommon.  Anyone else experienced and solution? Thank you.

[John C Hagan III, MD, FACS, FAAO]

You were told correct. Is common. Is called either "retained cortex" soft part that often disolves or is easily vacuumed up later, or "retained nucleus" hard part that does not disolves and usually has to be picked out of eye with forceps.

Happened to me more than once and to every surgeon.

JCH MD

[armida]

Thank you for your rsponse.  How exactly is this vacuumed up?  Does this involve the process of Vitrectomy?  Been told Dr. will re-enter at earlier incision with a curved instrument and vacumm.  Am concerned because it is "stuck" in center of eye.  

[John C Hagan III, MD, FACS, FAAO]

It's vacuumed with a instrument that goes inside the eye (like a tiny vacuum cleaner). In fact I've designed an instrument for just such a thing.  In the center of the eye is not a big deal in some cases its easier than if its in the periphery and attached to the capsule.

JCHMD

[armida]

Thank you for your comments.  Resting easier.  
Just read your report on Premium IOL's.   Since so much is done via internet, heartening to see your use of it.  Wonder how many MD's find time to read the patient comments on webites such as these?  Might be helpful though I understand time constraints.  Keep up the wonderful work.

[John C Hagan III, MD, FACS, FAAO]

I'm sure the number of physicians reading these posts is next to zero. Time crunch.  When they have time they usually are "learning" on educational sites.

We have been looking for another ophthalmologist to help with forum answers for over three years. Very difficult to find a busy physician that has an hour to spare every other day to answer questions for free.

JCHMD

[Eyefixer2]

Retained cortex is a very common finding as sometimes the pupil is so small you can not see all of the lens material. Most small amounts of cortex will disolve over time and not be an issue. It is very common for some surgeons to leave the "subincisional" cortex or the small strands under the area the surgeons enter the eye, as the fear of breaking the capsular bag that will hold you new implant is very high. If it was my eye I would prefer the retianed cortex over a broken bag and more risks of complications such as retinal detachment. Dont lose faith in your doctor as at the time it was probably the safest decision. Best of luck to you.
Sam