Bilateral dead bag syndrome

Abstract

Introduction: Posterior capsular rupture (PCR) is defined as breach in the continuity of the posterior part of the capsular bag in the human crystalline lens. Dead bag syndrome (DBS), a term coined by Samuel Masket, is a rare late complication of cataract surgery, which may present with spontaneous posterior capsular tear, causing intraocular lens (IOL) decentration or dislocation. It is usually seen in patients who have undergone an uneventful phacoemulsification with in-the-bag posterior chamber IOL implantation many years ago. Patient and Clinical Findings: A 73-year-old man presented with reduced vision in the right eye 17 years after an uneventful phacoemulsification and in-the-bag posterior chamber IOL implantation. There was no history of trauma to the eye. On examination, a decentered IOL with an inferior PCR was noted. Diagnosis, Intervention, and Outcomes: Decentered IOL was explanted, and a retro-iris–fixated IOL was implanted. Similar findings were noted in the left eye 4 years after the involvement of the right eye. There was no IOL dislocation or decentration. A diagnosis of DBS as the cause of PCR was made. The left eye was managed conservatively, and the patient remains under observation. Conclusions: The case described here seems to correspond to bilateral DBS. Physicians should be alert to look for the possibility of development of a similar complication in the other eye.