Unilateral capsular phimosis with an acrylic IOL and two capsular tension rings in pseudoexfoliation

Postoperative occlusion of visual axis with fibrous membrane in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome: a case report

“…Although hydrophilic acrylic IOLs with square-edge design and four haptics are expected to have enhanced uveal biocompatibility and capsular support [3, 13, 14], a few cases of anterior capsular phimosis after implantation of these IOLs were reported [4, 5, 15]. Notably, most of the cases were associated with pseudoexfoliation syndrome [4, 5]. There have been several case reports of anterior capsular phimosis in patients with pseudoexfoliation syndrome despite the insertion of capsular tension ring [3, 5, 16].…”

“…Notably, most of the cases were associated with pseudoexfoliation syndrome [4, 5]. There have been several case reports of anterior capsular phimosis in patients with pseudoexfoliation syndrome despite the insertion of capsular tension ring [3, 5, 16]. Pseudoexfoliation syndrome appears to significantly increase the risk of anterior capsular phimosis due to the following reasons: 1) As capsular shrinkage is conceivably associated with an imbalance between centripetal and centrifugal forces that act on the zonules and the capsulorhexis edge [3], zonular weakness can exaggerate the contraction response.…”

“…It was described as an exaggerated fibrotic response reducing the size of the anterior capsulorhexis opening and equatorial capsular diameter [1]. It typically occurs in patients with conditions of zonular weakness and intraocular inflammation [1, 2], such as pseudoexfoliation [3–5], uveitis [1, 2], myotonic dystrophy [2], and retinitis pigmentosa [6]. …”

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

“…The literature data shows that CCS has occurred in eyes with and without risk factors after the implantation of every IOL type (PMMA, silicone and acrylic); however, looking at the most recent reports, CCS has mainly developed after hydrophilic acrylic IOL implantation (in 1 case after implanting Akreos MI60 [18], in 1 case after Raysoft 574 R, Rayner Intraocular lenses, Ltd. [23], in 1 case after Bioacryl, Biotech [23], in 5 cases after Quatrix IOL, Croma Pharma GmbH [22], and in 6 cases after implanting an Akreos IOL lens [19, 20, 21]) (table 1). …”

“…The material and design of intraocular lenses (IOLs) have been hypothesized to play a role in anterior capsule opacification, the milder form of the disease [2]. However, CCS has been reported to occur with different types of IOLs, including polymethylmethacrylate, silicone and acrylic [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24]. Herein, we illustrate 2 cases of CCS following microincision cataract surgery without any associated ocular or systemic disease and we also review the literature on the subject (table 1).…”