J Korean Ophthalmol Soc.  2013 May;54(5):716-722. 10.3341/jkos.2013.54.5.716.

Early Capsular Block Syndrome after Phacoemulsification with Posterior Chamber IOL Insertion Combined with Vitrectomy

• Lee SJ
• Kim HY
• Oum BS
• Lee JE

• KMID: 2217036
• DOI: http://doi.org/10.3341/jkos.2013.54.5.716

Abstract

PURPOSE
To report early capsular block syndrome (CBS) after phacoemulsification with posterior chamber intraocular lens (IOL) insertion combined with vitrectomy.
METHODS
Medical records of 622 eyes of 589 patients who had combined phacoemulsification, IOL implantation and vitrectomy between March 2009 and December 2011 were retrospectively reviewed. Among patients with CBS occurring within 1 month of surgery, the patient's baseline characteristics, type of IOL and ophthalmic viscoelastic devices were analyzed.
RESULTS
Nine patients (1.45%) developed CBS with typical capsular bag distension. All CBS occurred within 2 weeks after the surgery. Hydrophilic, large optics and no angulation between optic and haptic were related with the occurrence of CBS. Nd:YAG laser capsulotomy (5 eyes), and surgical capsulectomy (2 eyes) resolved CBS successfully. In 2 eyes with gas tamponade, CBS resolved without intervention with the absorption of gas.
CONCLUSIONS
CBS may develop after phacoemulsification with PC IOL insertion combined with vitrectomy and/or vitreous tamponade. Hydrophilic material, large optics and no angulation were risk factors of capsular block by enhancing adhesion between the capsulorrhexis and the optic.

Keyword

Capsular bag distension syndrome; Capsular block syndrome; Combined surgery; Myopic shift

MeSH Terms

Absorption
Capsulorhexis
Eye
Humans
Lenses, Intraocular
Medical Records
Phacoemulsification
Retrospective Studies
Risk Factors
Vitrectomy

Figure

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  Figure 1. (A) Slit lamp biomicroscopy shows decreased anterior chamber depth, distended capsular bag (arrows). and IOP increas-ing, corneal edema. (B) After silicone oil removal with surgical posterior capsulectomy, corneal edema resolved and anterior cham-ber depth is normal.

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  Figure 2. (A) Slit lamp biomicroscopy shows accumulation of fluid between the IOL optic and the posterior capsule (arrows). (B) The fluid resolved 5 days later as intravitreal gas decreased.

Reference

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