Capsular block syndrome presenting with a hyperopic shift

Abstract

We report a case of late postoperative capsular block syndrome presenting with a hyperopic shift and discuss possible causes of this unusual presentation.

Late capsular block syndrome presenting with posterior capsule opacification

“…1 Late postoperative CBS and the associated refractive findings, including a myopic shift, no change in refraction, and a hyperopic shift, have been well documented in the literature. 5,12,13 Patients with late postoperative CBS have decreased visual acuity, impaired contrast sensitivity, and glare disability because of PCO and accumulated fluid in the bag. [3][4][5][6]10,[12][13][14] In our cases, no patient reported these symptoms except gradually decreased vision.…”

“…Although PCO and late postoperative CBS are usually treated by creating an opening in the posterior capsule with an Nd:YAG laser, 3,5,13 this can fail in some cases and surgical drainage of the entrapped fluid must be performed. 14 The cause of failure is reported to be that the laser beam could not be accurately focused on the posterior capsule because of the intense opacity of the contents in the distended capsular bag.…”

Surgical management of late capsular block syndrome

“…9 A normal ACD has been reported in several eyes with late postoperative CBS. [9][10][11] In addition to a myopic shift, refractive findings associated with late CBS include no change in refraction 9 or a hyperopic shift. 11 These findings are the result of slight anterior IOL displacement and the concave lens effect of the accumulated milky fluid containing cell debris.…”

“…[9][10][11] In addition to a myopic shift, refractive findings associated with late CBS include no change in refraction 9 or a hyperopic shift. 11 These findings are the result of slight anterior IOL displacement and the concave lens effect of the accumulated milky fluid containing cell debris. 11 Shah and Goulstine 11 hypothesize that in cases of late postoperative CBS, anterior IOL displacement is slight and the bag distends posteriorly.…”

“…11 These findings are the result of slight anterior IOL displacement and the concave lens effect of the accumulated milky fluid containing cell debris. 11 Shah and Goulstine 11 hypothesize that in cases of late postoperative CBS, anterior IOL displacement is slight and the bag distends posteriorly. The chronicity gives the capsule time to expand and accommodate fluid without pushing the IOL forward, as happens in acute postoperative cases.…”