Capsular bag distension syndrome after uneventful DMEK for Fuchs corneal endothelial dystrophy

Abstract

AbstractPurpose: Capsular bag distension syndrome or capsular block syndrome is a rare complication of cataract surgery characterized by accumulation of fluid between the intraocular lens and the posterior lens capsule, leading to visual deterioration. A small continuous curvilinear capsulorhexis, residual cortical lens material, as well as residual viscoelastic material behind the intraocular lens are associated with increased risk of fluid entrapment. Capsular bag syndrome usually occurs in the early postoperative period, but it has also been described as late as 14 years after cataract surgery. Nd‐YAG laser posterior capsulotomy is the treatment of choice in most cases, facilitating the drainage of the fluid in the vitreous cavity. Late‐onset capsular block syndrome is often associated with Propionibacterium acnes, requiring surgical management.Methods: Hereby we report a case of a 72‐year‐old female patient with Fuchs corneal endothelial dystrophy, who developed a capsular block syndrome after an uneventful endothelial keratoplasty (DMEK).Results: In the early postoperative period after the DMEK, we observed the development of capsular block syndrome OS. The patient was subjected to bilateral cataract surgery 6 years ago. After intensive follow‐up examination for excluding Propionibacterium acnes‐related endophthalmitis, we proceeded with Nd‐YAG capsulotomy, which resulted in drainage of the fluid in the vitreous cavity and immediate visual recovery.Conclusions: To our knowledge this is the first report of capsular bag syndrome after DMEK and therefore anterior segment surgeons should be aware of this rare complication.