Czech and Slovak Ophthalmology 110 10.31348/2019/1/6 Case report Late Postoperative Capsular Bag Distension Syndrome Otrošinová Marianna https://orcid.org/0000-0002-4279-8976 Novák Jan 20 7 2019 1 6

Purpose: Capsular bag distension syndrome is to be seen as a relatively rare complication after cataract surgery. Materials and Methods: We describe our experience of late-onset capsular bag distension syndrome with one case onset 4 years after cataract surgery. Nowadays diagnostic imaging methods were used. The literature was reviewed to summarize the diagnosis, classification, use of diagnostic aids, and the current treatments for the capsular bag distension syndrome. Visual acuity was assessed using the ETDRS (Early Treatment Diabetic Retinopathy Study) chart. Discussion: A 72-year-old woman presented with decreased visual acuity and blurred vision 4 years after phacoemulsification with continuous curvilinear capsulorhexis (CCC) and in-the-bag IOL implantation. After the slit lamp examination, patient was investigated with Scheimpflug camera (OCULUS Pentacam HR) and anterior segment spectral domain OCT (Optovue, Avanti RTVue XR), which confirmed the diagnosis of capsular block syndrome. Aspiration of the turbid fluid behind the lens and capsular bag lavage resulted in resolution of her symptoms. Aspirated fluid was examined. We have observed no CBS recurrence. Conclusion: CBS is the relatively rare complication of the standard cataract surgery, which can occur during surgery and in a postoperative period. CBS can be solved successfully after regular diagnosis using modern imaging methods.

 capsular bag distension syndrome capsular block syndrome CBS OCT Pentacam References Basti, S., Nayak, H., Mathur, U.: Capsular bag distension after optic capture of a sulcus-fixated intraocular lens. J Cataract Refract Surg, 25; 1999: 293–295. Bhattacharjee, H., Bhattacharjee, K., Bhattacharjee, P.: Liquefied after cataract and its surgical treatment. Indian J Ophthalmol, 62; 2014: 580–584. Davison, JA.: Capsular bag distension after endophacoemulsification and posterior chamber intraocular lens implantation. J Cataract Refract Surgb, 16; 1990: 99–108. Durack, I., Ozbeck, Z., Ferliel, ST. et al.: Early postoperative capsular block syndrome. J Cataract Refract Surg, 27; 2001: 555–559. Eifrig, DE.: Capsulorhexis-related lacteocrumenasia. J Cataract Refract Surg, 23; 1997: 450–454. Hashimoto, T., Izutani, M., Tanaka, Y. et al.: Two cases of posterior capsular rupture and dislocation of lens nucleus following hydrodissection. Folia Ophthalmol Jpn, 45; 1994: 973–976. Holtz, SJ.: Postoperative capsular bag distension. J Cataract Refract Surg, 18; 1992: 310–317. Killoran, E., Haugsdal, J., Oetting, TA.: Capsular block syndrome: An unusual presentation. EyeRounds.org [online]. 2016 [cit. 2018-11-03]. Dostupné na WWW: <https:// webeye.ophth.uiowa.edu/eyeforum/cases/238-capsular- -block-syndrome.htm>. Kim, HK., Shin, JP.: Capsular block syndrome after cataract surgery: clinical analysis and classification. J Cataract Refract Surg, 34; 2008: 357–363. Kollias, AN., Vogel, MA., de Kaspar, HM. et al.: Grueterich M Proprionibacterium acnes in capsular bag distension syndrome. J Cataract Refract Surg, 36; 2010: 167–169. Kucukevcilioglu, M., Hurmeric, V., Erdurman, FC. et al.: Imaging late capsular block syndrome: ultrasound biomicroscopy versus Scheimpflug camera. J Cataract Refract Surg, 37; 2011: 2071–2074. Liu, TY., Chou, PI.: Capsular block syndrome associated with secondary angle-closure glaucoma. J Cataract Refract Surg, 27; 2001: 1503–1505. Marback, EF., Araújo, RCA., Freitas, MS.: Síndrome do bloqueio capsular precoce relato de caso e especulação sobre o tamanho da parte óptica da lente como fator de risco. Rev Bras Oftalmol, 68; 2009: 344–347. Mardelli, PG., Mehanna, CJ.: Phacoanaphylactic endophthalmitis secondary to capsular block syndrome. J Catarct Refract Surg, 33; 2007: 921–922. Masket, S.: Postoperative complications of capsulorhexis. J Cataract Refract Surg, 19; 1993: 721–724. Miyake, K., Otta, I., Ichihashi, S. et al.: New classification of capsular block syndrome. J Cataract Refract Surg, 24; 1998: 1230–1234. Miyake, K., Ota, I., Miyake, S. et al.: Liquefied after cataract: a complication of continuous curvilinear capsulorhexis and intraocular lens implantation in the lens Capsule. Am J Ophthalmol, 125; 1998: 429–435. Miyake, K., Ota, I., Miyake, S. et al.: Capsular block syndrome with external blockage of the capsular opening by a ciliary sulcus fixated posterior chamber lens. Am J Ophthalmol, 127; 1999: 605–607 Nishi, O., Nishi, K., Takahashi, E.: Capsular bag distension syndrome noted 5 years after intraocular lens implantation. Am J Ophthalmol, 125; 1998: 545–547. Omar, O., Eng, CT., Chang, A. et al.: Capsular bag distension with an acrylic intraocular lens. J Cataract Refract Surg, 22; 1996: 1365–1367. Osher, RH., Yu, BCY., Koch, DO.: Posterior polar cataracts: a predisposition to intraoperative posterior capsular rupture. J cataract Refract Surg, 16; 1990: 157–162. Ota, I., Miyake, S., Miyake, K.: Dislocation of the lens nucleus into the vitreous cavity after standard hydrodissection. Am J Ophthalmol, 121; 1996: 706–708. Qu, J., Bao, Y., Li, M. et al.: Surgical management of late capsular block syndrome. J Cataract Refract Surg, 36; 2010: 1687–1691. Starr, MB.: Capsular bag distension syndrome noted 5 years after intraocular lens implantation. Am J Ophthalmol, 127; 1999: 244–245. Sugiura, T., Miyauchi, S., Eguchi, S. et al.: Analysis of liquid accumulated in the distended capsular bag in early postoperative capsular block syndrome. J Cataract Refract Surg, 26; 2000: 420–425. Theng, JT., Jap, A., Chee, SP.: Capsular block syndrome: a case series. J Cataract Refract Surg, 26; 2000: 462–467. Wendrix, G., Zeyen, T.: Late-onset capsular bag distension syndrome after cataract surgery: 2 case-reports. Bull Soc Belge Ophthhalmol, 301; 2006: 67–69. Yeoh, R., Theng, J.: Capsular block syndrome and pseudoexpulsive hemorrhage. J Cataract Refract Surg, 26; 2000: 1082–1084.