Abstract

P 134

Early focal Nd:YAG-capsulotomy for the treatment of a patient with incomplete capsular-block-syndrome after phacoemulsification and implantation of an intraocular lens

Sami Saleh, Zisis Gatzioufas, Ursula  Löw, Frank  Schirra, Karin Brückner, Berthold Seitz
Klinik für Augenheilkunde, Universitätskliniken des Saarlandes, Homburg/Saar

Introduction
We report on a patient with incomplete capsular block syndrome (iCBS) after cataract surgery, which has been successfully treated with focal Nd:YAG-laser-capsulotomy.
Patient
A 60-year-old female patient underwent cataract surgery with implantation of a posterior chamber intraocular lens in the right eye. The target refraction was -0.5 dioptres. The best corrected visual acuity at the first postoperative day was 0.8 and the objective refraction was -2.50/-1.0/154°. One week postoperatively, the patient complained of visual reduction and the best corrected visual acuity was down to 0.4. Slit-lamp examination showed an accumulation of transparent fluid between the posterior lens surface and the posterior capsular bag. This finding was also documented with the aid of Pentacam. The intraocular pressure was 14 mmHg and the anterior chamber angle was open. Interestingly, there was still a myopic shift present (objective refraction: -2,5/-1.0/154°). Based on this observation we made the diagnosis of iCBS.
Results:
We prescribed anti-inflammatory eye drops and after one week a focal Nd:YAG capsulotomy at 6 o’ clock was performed. After 5 days the evacuation of the trapped liquid was complete and visual acuity improved to 0.7. Three weeks after capsular block the best corrected visual acuity increased to 0.9 (objective refraction: -1.25/-0,75/159°).
Conclusions:
Capsular block syndrome represents a rare complication of cataract surgery. It is characterised by accumulation of liquid between the posterior capsule and the intraocular lens and can lead to visual reduction, lens shifting towards the anterior chamber, induced myopia, anterior chamber angle closure and elevation of the intraocular pressure. Our patient manifested an incomplete capsular block-syndrome with visual reduction but without IOP elevation. The early focal 6 o’clock capsulotomy has led to early recovery of refraction and visual acuity.

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