Imaging late capsular bag distension syndrome: an anterior segment optical coherence tomography study

Abstract

BackgroundAnterior segment optical coherence tomography (ASOCT) was used to categorize and provide insights into the etiology of capsular bag distension syndrome (CBDS).MethodsA prospective review was undertaken of 10 cases who presented with signs of late CBDS 5–11 years after uneventful phacoemulsification with in-the-bag posterior chamber intraocular lens implantation.ResultsAll 10 patients presented with a milky collection within the distended capsular bag without raised intraocular pressure or a shallow anterior chamber. ASOCT was used to confirm the diagnosis in all cases, and a hyperintense signal was seen in the space between the posterior chamber intraocular lens and the posteriorly bowed posterior capsule. The continuous curvilinear capsulorhexis was measured to be between 3.18 mm and 4.70 mm. Three cases had uncorrected visual acuity better than 6/12. Uncomplicated Neodymium-doped Yttrium Aluminium Garnet (Nd:YAG) posterior capsulotomy was performed in eight patients, with no resulting change in the intraocular lens position (measured by ASOCT) or subjective refraction.ConclusionOur study showed that ASOCT is a useful modality to differentiate this condition clearly from posterior chamber intraocular lens opacification and to investigate its causation. Nd:YAG posterior capsulotomy proved to be a safe and successful treatment for late CBDS with no change in biometric or refractive parameters.

Scheimpflug imaging of ultra-late postoperative capsular block syndrome

“…Limited research has been conducted on the changes of ACD in late CBS. Some studies 16,17 found small changes in ACD after laser treatment, as measured by anterior segment OCT. In our three cases, however, an increase in ACD after laser treatment was evident, ranging from 0.20 to 0.45 mm.…”

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

“…Nd:YAG posterior capsulotomy was performed in all the cases safely and yielded excellent visual results in all cases, with minimal biometric or refractive changes. Few reports demonstrated that in CBDS, distended capsular bag due to trapped milky fluid poses technical difficulty in focusing of the Nd:YAG laser on the posterior capsule, hence leading to failure, which may then require surgical drainage of the trapped fluid [15]. In all our cases, Nd:YAG laser assisted posterior capsulotomy was done in mid-periphery in the inferior part, as distension of bag leads to backward displacement of posterior capsule and therefore, center of posterior capsule cannot be visualized and focused.…”

In Vivo Observation of Lens Regeneration in Rat Using Ultra-Long Scan Depth Optical Coherence Tomography

“…It has been used in examination and analysis of the retina, 6,7 nerve fiber layer 8,9 , cornea, 10,11 and other structures in anterior segments. 10,11 In lens study, it has also been used to assess cataract 12 and PCO formation [13][14][15][16][17][18][19] in human eyes. Since OCT is an ideal tool to observe the structural changes of tissues longitudinally, it has been applied in contact lens edge fitting 20,21 and tear film assessment.…”