Capsular bag distention syndrome: case series and management strategies

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:00

Paper Time: 14:50

Venue: Room 3.6

First Author: : A.Vlasenko RUSSIA

Co Author(s): :    B. Malyugin   A. Verzin   D. Uzunyan              

Abstract Details

Purpose:

Capsular bag distension syndrome (CBDS) or late postoperative capsular block syndrome is characterized by complete occlusion of capsulorhexis opening by intraocular lens (IOL) optic and presence of liquefied content behind the IOL within the capsular bag (retro-optical space). In this study we report the clinical findings of different CBDS types determining follow-up and treatment options and suggest our concept of CBDS formation.

Setting:

S.Fyodorov Eye Microsurgery Institution, Moscow, Russia

Methods:

Prospective, observational, non-comparative case series including 17 eyes of 16 patients (10 men, 6 women) with the mean age of 66,9 ±11,9 (range 44-88), who underwent uneventful phacoemulsification and in-the-bag IOL implantation 2-11 years earlier (mean 4.9±2.8 years). Mean axial length was 24.7± 1.7 mm (range 22.49-28.44). Implanted IOLs included single-piece hydrophobic acrylic IOLs (AcrySof various models -13 eyes, Hoya- 3 eyes) and a single-piece hydrophylic acrylic IOL (Hanita-1 eye). Retro-optical contents characteristics; posterior capsule opacification (PCO), Soemmering’s ring and its connection with the retro-optical space were evaluated with slit-lamp biomicroscopy and optical coherence tomography (OCT) (Optovue).

Results:

In 4 cases retro-optical liquid and posterior capsule were transparent (CBDS type 1). In 6 cases liquid was transparent or semi-transparent, and PCO was observed (CBDS type 2). In 2 cases posterior capsule was transparent, but the content was either semi-transparent or opaque (CBDS type 3). In 5 cases opaque content and PCO were detected (CBDS type 4). Channels connecting Soemmering’s ring and retro-optical space were visualized with OCT in 5 eyes. Management options included patients follow-up (for CBDS type 1), YAG-laser posterior capsule puncture (for CBDS type 3) or YAG-laser posterior capsulotomy (for CBDS type 2 and 4).

Conclusions:

We consider the types of CBDS presented here as different stages of the same process. Lens epithelial cells migration as well as products of its lysis passing into the retro-optical space behind the optic-haptic junction area are presumably one of the major mechanisms leading to CBDS formation. However the exact CBDS reasons are yet to be discovered.

Financial Disclosure:

NONE