Time course of changes in anterior chamber structures after Nd:YAG laser anterior capsulotomy for early-onset postoperative capsular block syndrome evaluated by AS-OCT

Abstract

A 69-year-old man underwent uncomplicated 25-gauge pars plana vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation for treatment of epiretinal membrane. On postoperative day 1, a shallow anterior chamber and an anterior displacement of the IOL with pigment dispersion were observed. Swept-source anterior segment optical coherence tomography (AS-OCT) revealed a capsular hyperexpansion with ciliochoroidal detachment, and the patient was diagnosed with early-onset postoperative capsular block syndrome (CBS). After peripheral anterior capsulotomy by Nd:YAG laser on postoperative day 1, the IOL displacement was resolved immediately, and a transient reverse pupillary block was detected by AS-OCT. A resolution of the reverse pupillary block and ciliochoroidal detachment was confirmed by AS-OCT on postoperative day 3. To our knowledge, this is the first case that describes the postoperative time course and a transient reverse pupillary block after Nd:YAG anterior capsulotomy for early postoperative CBS using swept-source AS-OCT images.