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Late postoperative capsular block syndrome: a case series studied before and after Nd:YAG laser posterior capsulotomy

Abstract

Purpose

To evaluate the clinical characteristics of the unusual late postoperative capsular block syndrome (CBS) and the effect of Nd:YAG laser posterior capsulotomy on visual acuity and refractive error as well as its possible complications.

Methods

In this retrospective cohort study, 12 eyes of 11 patients with late CBS who had undergone Nd:YAG laser posterior capsulotomy were reviewed. A complete ophthalmic examination including Scheimpflug camera and anterior segment optical coherence tomography (AS-OCT) imaging had been performed before and after posterior capsulotomy.

Results

The mean time between cataract surgery and posterior capsulotomy was 4.7 ± 1.5 years (range 3-9 years). Best-corrected visual acuity increased in 11 cases (91.7%). Only one eye showed a 0.5-D hyperopic shift following posterior capsulotomy. There were no postlaser complications such as increased intraocular pressure (IOP), severe inflammation, cystoid macular edema, or retinal detachment. In all patients, the posterior capsule was vaulted posteriorly and could not be seen clearly. The AS-OCT confirmed CBS in the studied cases, demonstrating a distended capsular bag. Rotating Scheimpflug imaging examination showed the white substance located behind the intraocular lens (IOL).

Conclusions

Late CBS is usually not accompanied by shallow anterior chamber, forward IOL displacement, or raised IOP. Nd:YAG laser posterior capsulotomy is a useful treatment and the prognosis of patients with this complication appears favorable. Furthermore, although AS-OCT measurements are easier to obtain than rotating Scheimpflug imaging examination, both are useful to visualize the distended capsular bag containing the white material and the IOL position.

Eur J Ophthalmol 2015; 25(1): 27 - 32

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Lens/Cataract

DOI:10.5301/ejo.5000507

Authors

Valentín Huerva, M. Carmen Sánchez, Francisco J. Ascaso, Jordi Soldevila

Article History

Disclosures

Financial Support: No financial support was received for this submission.
Conflict of Interest Statement: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Department of Ophthalmology, Hospital Universitari Arnau de Vilanova, Lleida - Spain
  • Department of Ophthalmology, Policlinic Lleida, Lleida - Spain
  • Department of Ophthalmology, Hospital Clínico Universitario “Lozano Blesa”, Zaragoza - Spain
  • Instituto Aragonés de Ciencias de la Salud, Zaragoza - Spain

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