Capsule Contraction Syndrome with a Microincision Foldable Hydrophilic Acrylic Intraocular Lens: Two Case Reports and Review of the Literature

Balestrazzi, Angelo; Malandrini, Alex; Martone, Gianluca; Marigliani, Davide; Caporossi, Tomaso; Tosi, Gian Marco

doi:10.1159/000368344

Cited by 9 publications

(11 citation statements)

References 24 publications

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“…Mydriatic examination should be conducted when patients complain of vision or visual change in order to detect CCS early and provide timely treatment. Laser and surgery are the primary treatments for CCS (25,26). However, in some severe cases or cases not suitable for laser treatment, surgery is the sole choice.…”

Section: Discussionmentioning

confidence: 99%

Application of capsular bag relaxation for capsular contraction syndrome

Zhang

2020

Exp Ther Med

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The present study analyzed the surgical method and clinical effects of capsular bag relaxation surgery (CBRS) for the treatment of capsular contraction syndrome (CCS), which usually occurs post-phacoemulsification. The retrospective case study comprised of a total of 25 patients (25 eyes) who developed CCS after phacoemulsification and subsequently underwent CBRS. Among these patients, 15 patients (15 eyes) received actinoid relaxing incisions and 10 patients (10 eyes) underwent a second continuous curvilinear capsulorhexis. Postoperative naked-eye visual acuity was determined and compared with preoperative naked-eye visual acuity. Size changes of the transparent zone of the anterior capsule opening were observed under a slit lamp, as well as the anterior and posterior capsular membrane conditions and position of the intraocular lens (IOL). In addition, the presence of any subjective symptom, including glare or monocular diplopia, was investigated. A final 6-month postoperative follow-up was conducted for each patient. Visual acuity of all operated eyes improved to various extents. Notably, glare and monocular diplopia were no longer evident and patients could observe things clearly. Visual differences pre-and post-surgery were statistically significant (u=5.143, P<0.01). In addition, capsular bag shrinkage and relaxation were revealed under a slit lamp, the area of the transparent zone of the anterior capsule opening was expanded and the IOL remained centered. To conclude, CBRS is an effective treatment method for patients with CCS who are not suitable to receive laser treatment.

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Section: Discussionmentioning

confidence: 99%

Application of capsular bag relaxation for capsular contraction syndrome

Zhang

2020

Exp Ther Med

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“…The thickness of PCL is usually constant and corresponds to the length of the cilia (3-10μm) [25][26]. Both layers are continuously transported by the synchronized rhythmic beating of cilia (the mucociliary transport -MCT) at a speed of about 3 mm/min towards the pharynx [1,17,26].…”

Section: Airways Surface Liquidmentioning

confidence: 99%

“…The airway epithelium is covered with a thin, liquid protective layer -Airways Surface Liquid (ASL) [1]. ASL is created and maintained by water and ion transport, especially sodium and chloride [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Its task is to create an ideal environment that allows proper gas exchange through the respiratory epithelium [9][10][11][12][13]. ASL is engaged in the purification and maintenance of airways, which is associated with providing the right degree of hydration and protection against irritants [1,3,[14][15]. It is the first protective barrier immobilizing microorganisms and impurities, which can then be easily expelled [16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Airways Surface Liquid and Ion Transport - The Mechanism Maintained Patency

Iwan

Dziembowska

Olszewska−Słonina

et al. 2019

BJSTR

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The airway epithelium is covered with a thin, liquid protective layer -Airways Surface Liquid (ASL), which is a hydrogel, 3-50μm thick. ASL is created and maintained by water (AQPs) and ion transport, especially sodium (ENaC), chloride (CFTR, ClC), potassium, bicarbonate and calcium. Epithelial cells secrete mucins, which role is to transport ASL towards the upper airways. ASL is the first protection mechanism against solid particles and microorganisms inhaled with air. The proper ASL hydration and functioning are influenced by internal factors, such as the activity of ion channels (especially ENaC and CFTR) and water (AQPs), ciliary function, nerve endings irritation, influx of immunocompetent cells and current hormonal status. External factors affecting hydration are colonization by microorganisms and inhalation of irritants. Developing inflammation, cough, and drugs affect the functions of ion channels, thereby changing the ASL volume and composition, hindering or facilitating self-purifying and flow through airways. The aim of this study was to collect reliable scientific data concerning physiological and pathological changes in ASL volume and composition.

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“…The anterior capsule opacity(ACO) and shrinkage may decrease visual function [ 2 ]. The development of CCS can lead to IOL decentration [ 3 ], IOL dislocation [ 4 ], and even ciliary body detachment [ 5 ]. Previous studies showed that CCS was more prevalent among patients with some preexisting ocular or systemic disorders, such as high myopia [ 6 ], retinitis pigmentosa [ 7 ] and diabetes mellitus [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Case series: “Double arch” changes caused by capsule contraction syndrome after cataract surgery in highly myopic eyes

Wang

Liu

et al. 2021

BMC Ophthalmol

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Background Capsule contraction syndrome (CCS) after cataract surgery causes intraocular lens (IOL) haptic flexion and IOL optic displacement in most former reports. However, there are few reports on CCS-induced deformation of the IOL optic. We report two cases of CCS after cataract surgery in highly myopic eyes and describe a previously unreported “double arch” complication. Case presentation Two patients with history of high myopia had cataract surgery with hydrophilic acrylic plate haptic IOLs implanted in their eyes. CCS with arch shape deformation of the pupil as well as the optic of the IOL were noticed in both cases after three months, which induced refractive changes and corrected distance visual acuity (CDVA) deterioration. Visual acuity of the patients was restored by replacing the IOL from the capsular bag to the ciliary sulcus and the following neodymium: YAG (Nd:YAG) laser capsulotomy. We propose that such “double arch” change brought by CCS is related to the plate-haptic design of the IOL and the incomplete overlap between the capsular opening and the IOL optic. Conclusions We recommend careful IOL selection and proper capsulorhexis in patients with high myopia or with other risk factors of CCS. Early diagnosis and timely treatment of CCS are critical to prevent visual symptoms and further ocular complications.

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Capsule Contraction Syndrome with a Microincision Foldable Hydrophilic Acrylic Intraocular Lens: Two Case Reports and Review of the Literature

Cited by 9 publications

References 24 publications

Application of capsular bag relaxation for capsular contraction syndrome

Application of capsular bag relaxation for capsular contraction syndrome

Airways Surface Liquid and Ion Transport - The Mechanism Maintained Patency

Case series: “Double arch” changes caused by capsule contraction syndrome after cataract surgery in highly myopic eyes

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