Fikret UCAR, Muhammed SAĞDIÇ
Retina-Vitreus - 2026;35(3):292-298
Purpose: To report a case of chronic vision loss due to an occult retained lens nuclear fragment in the pars plana following complicated cataract surgery, and to describe the surgical management using pars plana vitrectomy (PPV) combined with the flattened haptic scleral fixation technique. Methods: A 72-year-old male presented with persistent visual disturbances (best-corrected visual acuity [BCV A] 0.1 decimal, intraocular pressure 19 mmHg) one year after cataract surgery. Examination revealed vitreous strands, vitreous in the anterior chamber, inferior IOL dislocation, vitreous haze, and cystoid macular edema (CME). Preoperative central macular thickness (CMT) was 478 µm. The patient underwent PPV with intrascleral IOL fixation using the flattened haptic tip technique. During peripheral vitrectomy with scleral indentation, a ~1.5 mm retained nuclear fragment was identified in the inferotemporal pars plana and removed. Results: At three months postoperatively, BCV A improved to 0.9 decimal, intraocular pressure was 16 mmHg, and CMT decreased to 268 µm. CME and vitreous haze completely resolved. The IOL remained well-centered without tilt or dislocation.Conclusion: Retained lens fragments in occult locations such as the pars plana can cause prolonged chronic inflammation, CME, and vision loss. Even when diagnosis is delayed beyond one year, combined PPV for fragment removal and flattened haptic scleral fixation effectively restores anatomical integrity and visual function. The flattened haptic technique provides superior IOL stability in eyes with compromised capsular support.
