Ultra-Late Onset Capsular Bag Distension Syndrome: Risk Factors and Characteristics on Scheimpflug Imaging

Rishiraj Singh Gaurav Gupta,Rohit Gupta Parul Chawla Gupta

doi:10.4172/2155-9570.1000465

Abstract

Background: To provide insights into the characteristic of ultra-late onset capsular bag distension syndrome (CBDS) after phacoemulsification. Design: An interventional, retrospective case series at a tertiary care institute. Participants: 5 Post-cataract surgery patients who presented with the retrolenticular fluid collection. Methods: This is an interventional, retrospective case series of 5 cases who presented with clinical signs of ultralate CBDS>7 years after uneventful phacoemulsification with in-the-bag posterior chamber intraocular lens implantation at a tertiary care institute. Scheimpflug imaging was used in all cases in addition to slit lamp biomicroscopic examination to assess and diagnose the condition. Neodymium:Yttrium Aluminium Garnet (Nd:YAG) posterior capsulotomy was performed in all to treat the condition. Main outcome measure: Results: All 5 patients presented with a milky fluid collection within the distended capsular bag without raised intraocular pressure or a shallow anterior chamber. Scheimpflug imaging confirmed the diagnosis in all cases and all eyes revealed a hyper-reflective space between the intraocular lens optic and the posterior capsule. Nd:YAG posterior capsulotomy was performed in all patients, with resolution of fluid and improvement of visual acuity. Conclusion: Our case series showed that Scheimpflug imaging is a useful modality to diagnose ultra-late onset CBDS and to differentiate this condition from intraocular lens opacification and posterior capsule opacification (PCO). Nd:YAG posterior capsulotomy proved to be successful treatment for ultra-late CBDS with no significant change in biometric or refractive parameters. Keywords: Ultra-late capsular bag distension syndrome;

Highlights

Capsular bag distension syndrome (CBDS) is a well-known entity with the reported incidence in clinically examined eyes of 0.73% in post cataract surgery patients [1]
In the early post-operative period, detection of capsular bag distension syndrome (CBDS) is easier as patient presents with clinical signs like reduced vision and myopic shift with forward displacement of the posterior chamber intraocular lens (IOL) and accumulation of retrolenticular fluid [4,5,6]
We reviewed the characteristics of the five eyes of five patients that were diagnosed as ultra-late onset CBDS during 2013-14 period

Summary

Introduction

Capsular bag distension syndrome (CBDS) is a well-known entity with the reported incidence in clinically examined eyes of 0.73% in post cataract surgery patients [1]. Use of Scheimpflug imaging showed a higher incidence of 26% in the early post-operative period but most of the patients were asymptomatic [2]. In the early post-operative period, detection of CBDS is easier as patient presents with clinical signs like reduced vision and myopic shift with forward displacement of the posterior chamber intraocular lens (IOL) and accumulation of retrolenticular fluid [4,5,6]. Zhu described characteristic Scheimpflug imaging in 3 ultra-late onset CBDS cases that presented after 7 years of phacoemulsification surgery [7]. To provide insights into the characteristic of ultra-late onset capsular bag distension syndrome (CBDS) after phacoemulsification.

Methods

Results

Conclusion