EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/947241
EW INTERNATIONAL 142 March 2018 Presentation spotlight by Stefanie Petrou Binder, MD, EyeWorld Contributing Writer A new classification system stages capsular bag distension according to levels of intracapsular fluid opacity and the presence of PCO C apsular bag distension syndrome (CBDS) is a rare complication of cataract surgery in which the capsular bag accumulates fluid between the IOL and the pos- terior capsule. The trapped fluid can cause an expansion of the posterior capsule and thus displace the IOL anteriorly. CBDS occurs in 0.73% of patients, according to the results of one study that retrospectively examined the charts of 1,100 eyes of 990 patients who had phacoemulsi- fication and posterior chamber (PC) IOL implantation. The study found that eyes with longer axial lengths of more than 25 mm as well as those with four-haptic PC IOLs, compared to C-loop IOLs, were at a higher risk of developing CBDS. The evaluation of clinical characteristics showed three distinct types of CBDS: noncel- lular, inflammatory, and fibrotic. 1 CBDS can be further classified according to the time of onset, as intraoperative, early postoperative, when occurring within the first few weeks following surgery, or late post- operative, when occurring months to years following surgery. 2 The occurrence of CBDS was found to be associated with continuous curvilin- ear capsulorhexis (CCC), according to this investigation. It postulated that intraoperative CBDS result- ed from high irrigation pressures during hydrodissection in cataract surgery that led to posterior capsule hyperdistension and could possibly lead to capsule rupture. Early postop CBDS was usually associated with incomplete viscoelastic removal behind the IOL, and manifested with anterior IOL displacement, an- terior chamber shallowing, myopic shift, and elevation of IOP. Finally, the study showed that late onset Capsular bag distension syndrome: Classification and management strategies Slit lamp examination of an eye with capsular bag distension syndrome type 3 Source: A. Verzin and B. Malyugin Optical coherence tomography image of capsular bag distension syndrome type 4 Source: A. Verzin, B. Malyugin, and D. Uzunyan