Late-Onset Capsular Block Syndrome: Unusually Delayed Presentation

Rana, Mrinal; Jiang, Li; Ilango, Balasubramaniam; Yang, Ya-Ting

doi:10.1159/000357398

Cited by 14 publications

(18 citation statements)

References 9 publications

(11 reference statements)

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“…Miyake et all characterised the syndrome according to the time of onset as intraoperative, early postoperative and late postoperative (6). In our cases, the time of CBDS appearance (8 and 6 years in the first and second patient respectively) was longer compared to the reported 4-5 years in most reports (3,(6)(7)(8)(9). In CBDS, the periphery of the capsulorrhexis is firmly attached to the anterior surface of the IOL so that a closed chamber between the intraocular lens and the posterior lens capsule is created.…”

Section: Discussionmentioning

confidence: 50%

“…With this approach, the turbid intracapsular fluid is drained into the anterior chamber and filtered through the natural outflow system of the eye. An alternative approach is the surgical aspira- tion of the fluid through the pars plana (6,8). In our cases, Nd:YAG laser posterior capsulotomy was very effective in evacuating the opaque, distended capsular bag and allowing the IOL to resume its normal position.…”

Section: Discussionmentioning

confidence: 68%

“…It should be noted, however, that the presence of Propionibacterium acnes in the fluid of CBDS cases has been documented (7). To minimize the possibility of Nd:YAG laser-induced Propionibacterium dissemination and endophthalmitis, a pars plana approach with intravitreal injection of antibiotics has been suggested (8). In our cases however, the decision to perform Nd:YAG capsulotomy was based on the total absence of even traces of anterior chamber or vitreous inflammation that could indicate infection by Propionibacterium.…”

Section: Discussionmentioning

confidence: 82%

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Late-Onset Capsular Bag Distension Syndrome: A Report of Two Cases

Zafeiropoulos¹,

Katsanos²,

Gorgoli³

et al. 2014

Acta Med. (Hradec Kralove, Czech Repub.)

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Capsular bag distension syndrome is a very rare complication of cataract surgery. Most cases occur after uneventful phacoemulsification with continuous curvilinear capsulorhexis and implantation of an intraocular lens in the capsular bag. The entity presents with reduction of visual acuity and myopic shift in the early-to-late postoperative period. Characteristic findings include the distension of the capsular bag due to the accumulation of milky material and the forward displacement of the intraocular lens. We present two cases with an unusually delayed presentation of 6 and 8 years respectively following phacoemulsification, and describe their successful management with Nd:YAG laser posterior capsulotomy.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 82%

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Late-Onset Capsular Bag Distension Syndrome: A Report of Two Cases

Zafeiropoulos¹,

Katsanos²,

Gorgoli³

et al. 2014

Acta Med. (Hradec Kralove, Czech Repub.)

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“…Several reports of late-onset CBS have also been verified to be related to Propionibacterium acnes ; hence, after posterior laser capsulotomy, P. acnes -associated endophthalmitis may occur [10, 11, 18, 19]. Moreover, posterior laser capsulotomy is difficult to perform because of opaque substance or severe expansion of the posterior capsule [12].…”

Section: Discussionmentioning

confidence: 99%

Outcome of Surgical Treatment in Late-Onset Capsular Block Syndrome

Huang

et al. 2017

Journal of Ophthalmology

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Purpose To further investigate the pathogenesis of late-onset capsular block syndrome (CBS) and to evaluate the safety of surgical treatment. Methods Seven patients diagnosed with late-onset CBS were retrospectively analyzed. Anterior chamber depth (ACD), intraocular pressure (IOP), refractive diopter, and best-corrected visual acuity (BCVA) before and after surgery were recorded. The opaque substance was tested with Western blot, and a flow cytometer multiple array assay system was utilized to evaluate the levels of inflammatory cytokines from opaque substance and aqueous humor, respectively. Results Patients who had undergone surgical treatment showed a significant BCVA and spherical equivalent refractive error improvement (P = 0.002, P = 0.021, resp.). Nevertheless, ACD and IOP before and after surgery were in normal range with no difference (P = 0.165, P = 0.749, resp.). αB-crystallin and βB-crystallin were detected in all opaque substances. Tumor necrosis factor-alpha (TNF-α) and interlukin-1β (IL-1β) levels in opaque substance were significantly higher than those in aqueous humor (P = 0.038, P = 0.007, resp.), while IL-2 and IL-6 were not detected in any samples. Conclusions Opaque substance is derived from human lens epithelial cells. Inflammatory cytokines may be involved in the pathogenesis of late-onset CBS. In addition, surgical treatment is an effective approach. This trial is registered with ChiCTR-IOR-17011287.

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“…Depending on the time of onset, Miyake et al classified CBDS as intraoperative, early and late postoperative [3]. In the early post-operative period, detection of CBDS is easier as patient presents with clinical signs like reduced vision and myopic shift with forward displacement of the posterior chamber intraocular lens (IOL) and accumulation of retrolenticular fluid [4][5][6]. Zhu described characteristic Scheimpflug imaging in 3 ultra-late onset CBDS cases that presented after 7 years of phacoemulsification surgery [7].…”

Section: Introductionmentioning

confidence: 99%

Ultra-Late Onset Capsular Bag Distension Syndrome: Risk Factors and Characteristics on Scheimpflug Imaging

Gupta¹,

Gupta²

2015

J Clin Exp Ophthalmol

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Background: To provide insights into the characteristic of ultra-late onset capsular bag distension syndrome (CBDS) after phacoemulsification. Design: An interventional, retrospective case series at a tertiary care institute. Participants: 5 Post-cataract surgery patients who presented with the retrolenticular fluid collection. Methods: This is an interventional, retrospective case series of 5 cases who presented with clinical signs of ultralate CBDS>7 years after uneventful phacoemulsification with in-the-bag posterior chamber intraocular lens implantation at a tertiary care institute. Scheimpflug imaging was used in all cases in addition to slit lamp biomicroscopic examination to assess and diagnose the condition. Neodymium:Yttrium Aluminium Garnet (Nd:YAG) posterior capsulotomy was performed in all to treat the condition. Main outcome measure: Results: All 5 patients presented with a milky fluid collection within the distended capsular bag without raised intraocular pressure or a shallow anterior chamber. Scheimpflug imaging confirmed the diagnosis in all cases and all eyes revealed a hyper-reflective space between the intraocular lens optic and the posterior capsule. Nd:YAG posterior capsulotomy was performed in all patients, with resolution of fluid and improvement of visual acuity. Conclusion: Our case series showed that Scheimpflug imaging is a useful modality to diagnose ultra-late onset CBDS and to differentiate this condition from intraocular lens opacification and posterior capsule opacification (PCO). Nd:YAG posterior capsulotomy proved to be successful treatment for ultra-late CBDS with no significant change in biometric or refractive parameters.

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Late-Onset Capsular Block Syndrome: Unusually Delayed Presentation

Cited by 14 publications

References 9 publications

Late-Onset Capsular Bag Distension Syndrome: A Report of Two Cases

Late-Onset Capsular Bag Distension Syndrome: A Report of Two Cases

Outcome of Surgical Treatment in Late-Onset Capsular Block Syndrome

Ultra-Late Onset Capsular Bag Distension Syndrome: Risk Factors and Characteristics on Scheimpflug Imaging

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