Late postoperative capsular bag distension syndrome with deepening of anterior chamber after Nd:YAG capsulotomy: optical coherence tomography study

Poster Details

First Author: GregorHawlina SLOVENIA

Co Author(s):    Darko Perovšek   Marko Hawlina           

Abstract Details

Purpose:

Late postoperative capsular bag distension syndrome (CBDS) is characterized by accumulation of liquefied material in a closed chamber inside the capsular bag. This type of CBDS occurs on average 3.8 years after cataract surgery and was defined without shallow anterior chamber and no change in anterior chamber depth after Nd:YAG capsulotomy. We present patient with sudden decrease in visual acuity due to late-postoperative CBDS with shallow anterior chamber. CBDS developed 4.5 years after cataract surgery and was treated by Nd:YAG laser posterior capsulotomy.

Setting:

: Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1525 Ljubljana, Slovenia.

Methods:

CBDS was diagnosed clinically. High-resolution spectral-domain optical coherence tomography (Heidelberg Engineering Spectralis) was used to present characteristics of posterior capsule dynamics before and after treatment. Additionally, IOL master was used to analyze changes in anterior chamber depth.

Results:

Patient was examined before Nd:YAG treatment, 20 minutes, 1 day and 3 months after treatment. After treatment, anterior chamber depth changed from 2.61 mm to 4.91 mm, intraocular pressure was within normal limits, there was no anterior chamber or vitreal inflammatory reaction and visual acuity improved from 0.7 to 1.0. Milky fluid from capsular bag leaked into vitreous and resolved in one day. Distance between IOL and the posterior capsule gradually changed from 1495 µm (maximal distance) to 165 µm at 3 months.

Conclusions:

OCT presents an important and valuable tool for CBDS analysis. Our case report is exceptional due to shallow anterior chamber which deepened after treatment. This is in contrast with Miyake’s definition of late-postoperative CBDS, characteristically described without changes in anterior chamber depth. FINANCIAL INTEREST: NONE