Lacteocrumenasia due to late capsular bag distension syndrome: three consecutive cases effectively treated by Nd:YAG laser posterior capsulotomy

In this paper, we describe three consecutive cases of capsular bag distension syndrome (CBDS) presenting 7 years, 6 years and 8 months after cataract surgery involving anterior continuous curvilinear capsulorhexis (CCC), phacoemulsification and intraocular lens (IOL) implantation in the capsular bag. In the affected patients, all of them men aged 67, 73 and 50 years, respectively, CBDS presented as reduced visual acuity in one eye. In all three patients, anterior chamber shallowing was observed and the space between the IOL and posterior capsule was filled with a cloudy milky fluid. No evidence of inflammation was detected in the anterior chamber or vitreous. In each case, the complication was resolved by low-energy Nd:YAG laser posterior capsulotomy, which effectively cleared the cloudy fluid into the vitreous cavity without consequence. Before making the decision to use this form of treatment, it is important to first rule out chronic endophthalmitis through differential diagnosis. J Emmetropia 2013; 4: 33-37 . Capsular bag distension syndrome (CBDS) is a postoperative complication of continuous curvilinear capsulorhexis (CCC) placed for intraocular lens (IOL) insertion following cataract extraction. The syndrome has been associated with the following features: postoperative myopic over-refraction, shallowing of the anterior chamber associated with anterior displacement of the IOL and iris diaphragm, posterior distension of the posterior capsule and sealing of the capsule on the anterior surface of the IOL1. Submitted: 11/08/2012 Revised: 12/16/2012 Accepted: 12/21/2012 1 Department of Ophthalmology. Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain. Financial disclosure: The authors have no proprietary interest in any of the materials described in this article. The contents of this report were presented as an oral communication at the XXVII Sociedad Española de Cirugía Ocular Implanto-Refractiva (SECOIR) Meeting, May 2326th, 2012, Seville, Spain. Corresponding Author: Ignacio Rodríguez-Uña. Hospital Clínico San Carlos, Prof. Martin Lagos Av, S/N, 28040 Madrid, Spain. E-mail: [email protected] CASE REPORTS The three patients described here were prospectively recruited from our ophthalmology department over the period between May 2011 and January 2012. All of them were men who had undergone phacoemulsification after anterior CCC and in-the-bag IOL placement. Following cataract surgery, no intraoperative or immediate postoperative complications had been described and best corrected visual acuity (VA) in each patient was 20/20. At the time of CBDS presentation, no clinical evidence of chronic endophthalmitis associated with Propionibacterium acnes was detected in the three individuals. The clinical features of the patients are provided in Table 1 and exploratory findings at the time of CBDS diagnosis are provided in Table 2.