Complete anterior capsule phimosis after routine cataract surgery

Abstract

A 79-year-old woman with pseudoexfoliation and zonular weakness underwent routine phacoemulsification with 5.5 mm capsulorhexis and implantation of posterior chamber intra-ocular hydrophobic lens (KSSPStaar®). Examination at one-week post-surgery was normal. One-month post-surgery, the vision had decreased to 20/200. Slit-lamp examination showed complete anterior capsular contraction syndrome with a thick central occluding membrane and decentered lens (Figure 1A). No inflammation of the anterior segment was noted. Because of the zonular weakness, YAG laser anterior capsulotomy was chosen rather than further intra-ocular surgery with scissors and cystotome. Radial impacts, performed as usual, failed to clear the thick central membrane, so we detach edit and let the operculum drop away from the visual axis (Figure 1B). This procedure allowed for visual clearance and 20/20 vision recovery.