Late dislocation of the capsular bag after phacoemulsification with endocapsular IOL in pseudoexfoliation syndrome

Abstract

PES has been associated with weakness of zonular attachments to the ciliary body and with late dislocation of the IOL following cataract extraction with in-the-bag IOL implantation. We evaluated the frequency of PES in patients with IOL dislocation following phacoemulsification cataract surgery. We retrospectively reviewed the records of five patients who had undergone phacoemulsification, followed by implantation of a posterior chamber IOL in the capsular bag during the years 1992 through 1996 and who showed IOL dislocation during follow-up. We looked for clinical signs of PES that had been noted prior to or after IOL dislocation. Detailed review of the records of these patients identified PES as a coexistent condition in all five. The most impressive clinical feature was shrinkage of the capsular bag to conform to the size and contour of the implanted IOL. In accordance with many histopathological and clinical studies supporting our findings, we suggest that shrinkage of the capsular bag can be reduced by not using foldable IOL, by early anterior YAG capsulotomy or by the use of an IOL with a larger optic.