Late postoperative capsular block syndrome: Entrapment of liquefied after-cataract by capsular bend

Abstract

We report a case of capsular bend-related entrapment of liquefied after-cataract that resulted in late postoperative capsular block syndrome in a 56-year-old man. Slitlamp examination showed a capsular bend formation at the square edge of the optic. Superiorly, leakage in the capsular bend resulted in fluid extending into Soemmering's ring, although communication with the anterior chamber was limited by the capsular bend. Fluid was seen between the lens and posterior capsule.

Late postoperative capsular block syndrome versus liquefied after-cataract

“…10,11,12 In CBS, anterior chamber shallowing, elevated IOP, unexpected myopic shift, and persistent uveitis are among the presenting features. In contrast, liquefied after-cataract has few symptoms other than the gray or white substance seen in the retrolenticular space.…”

Late-onset capsular block syndrome without lens displacement

“…5,6 The distension of posterior capsule, anterior chamber shallowing, unexpected myopic shift, and persistent uveitis are some of the presenting features. In our case, in contrast to the commonly reported earlier types, the structural changes in the anterior capsule with rigid fibrosis had prevented the displacement of IOL.…”

Late Postoperative Capsular Block Syndrome: A Case Series Studied before and after Nd:YAG Laser Posterior Capsulotomy

“…The treatment strategies for late postoperative CBS include anti-inflammatory eyedrops (6), slit-lamp needle revision of the capsular block (1, 20), surgical aspiration of the cortical masses and the fluid (1), and anterior or posterior capsulotomy using the Nd:YAG laser (5, 12-13-14, 17-18-19, 21-22-23). Nd:YAG laser posterior capsulotomy can be difficult to perform in some cases due to the opacity of the contents in a hyperdistended capsular bag (1, 23).…”

“…Dhaliwal et al (11) showed that this proteinaceous fluid may contain Propionibacterium acnes without any sign of inflammation or infection. This accumulation can cause distension of the capsular bag with forward displacement of the IOL, associated myopic shift (12)(13)(14), shallow anterior chamber, and occasionally secondary angleclosure glaucoma (2). Nevertheless, no change in refraction and hyperopic shift have been reported (15)(16)(17)(18)(19).…”