Immediate removal of posteriorly dislocated lens fragments through sclerocorneal incision during cataract surgery

Aim To describe a new method of removing dislocated nuclear fragments smaller than one-fourth the size of the lens nucleus through the sclerocorneal incision made for cataract surgery.

Methods Dislocated lens nuclear fragments on the surface of the retina were removed from six eyes of six consecutive patients. An anterior vitreous cutter with a 27-gauge chandelier endoilluminator (Twinlight illumination) tied to its sleeve was inserted into the eye through the incision made for cataract surgery and used for core vitrectomy. A fragmatome with another 27-gauge chandelier endoilluminator (Twinlight illumination) fibre was used to grasp and move the larger dislocated nuclear fragments into the anterior chamber where they were divided and removed.

Results All dislocated nuclear fragments were removed through the incision for cataract surgery, and a posterior chamber lens was implanted in each patient without major complications.

Conclusions The procedure can be used to remove dislocated lens nuclear fragments from the surface of the retina through the incision for cataract surgery. Neither a second surgery, which would require three ports, nor the body of instruments for vitreal surgery are needed with this procedure.