late onset capsular bag distension syndrome with solid material

purpose: to report a case of capsular bag distension syndrome (cbds) with solid material presenting eight years after cataract surgery. case report: a 58-years-old female who underwent an uneventful clear-cornea phacoemulsification with in-the-bag intraocular lens (iol) implantation in the right eye, presented with a chief complaint of blurred vision (va: 20/200) and cobweb like matter appearing in the visual field eight years after surgery. medical records showed postoperative visual acuity of 20/25 and normal ocular examination. on slit lamp examination, a normal anterior chamber, a well centered in-the-bag iol, and posterior bowing of the posterior lens capsule with accumulation of solid turbid materials in the space between the iol and the capsule were evident. the intraocular pressure was 17 mmhg in both eyes. other examinations were unremarkable. a low and then high energy nd:yag laser anterior capsulotomy was tried to evacuate debris which yielded no results. therefore, the materials were surgically removed from the capsular bag, resulting in an improvement of patient symptoms and an increase in visual acuity to 20/25. conclusion: late-onset cbds is an uncommon cause of late postoperative visual impairment following phacoemulsification and in-the-bag iol implantation. hence, an awareness of this syndrome will help cataract surgeons to manage this complication appropriately. yag laser capsulotomy is a safe therapeutic option with a rapid recovery; in special cases with solid materials not responding to this approach, surgical removal of the materials may be needed which has an excellent prognosis.