Postoperative Capsular Bag Distension Syndrome – Risk Factors and Treatment

ABSTRACT

Introduction:Postoperative capsular bag distension syndrome (CBDS) is a rare complication of cataract surgery which might occur in the early postoperative period, as well as several years after uncomplicated surgery. The aim of this study was to review the current evidence on postoperative capsular bag distension syndrome. Material and Methods: PubMed and Web of Science were used for literature search. Results: The typical presentation involves deterioration in visual acuity, unexpected myopic shift or less frequently hyperopia. In eyes with clear capsular fluid and no posterior capsule opacification, usually in the late postoperative period, CBDS can be asymptomatic. Risk factors for developing CBDS include retained ophthalmic viscoelastic device, inadequate subincisional cortex cleaning, apposition between the intraocular lens (IOL) and the capsular bag, postoperative inflammation and IOL sequestration with Propionibacterium acnes. Visualization of the CBDS can be aided with Scheimpflug imaging, ultrasound biomicroscopy, and particularly anterior-segment optical coherence tomography. Conclusion:Nd:YAG posterior capsulotomy, and in some cases anterior capsulotomy, is accepted as a standard and effective CBDS treatment. Surgical approach could be beneficial in cases suspected of Propionibacterium acnes presence or when it is impossible to perform Nd:YAG posterior capsulotomy.

Keywords:

• Capsular bag distension syndrome
• capsular block syndrome
• liquefied after cataract
• Nd:YAG posterior capsulotomy

Acknowledgments

The authors would like to thank Dr Gregor Hawlina from the Eye Hospital, University Medical Centre Ljubljana, Slovenia and Dr Matthew Tennant from the Department of Ophthalmology and Visual Sciences, University of Alberta, Canada for the critical discussion of the work.

Additional information

Funding

Not applicable.