Clinical presentation and management of anterior capsular contraction

  • Dr Vinita Ramnani Assistant Professor L.N. Medical College, Bhopal (M.P.), India
  • Dr Saroj Gupta Professor Peoples College of Medical Sciences and Research Center Bhopal (M.P.), India
  • Dr Vijay Kumar Ramnani Professor and Head, Department of Microbiology, LN Medical College, Bhopal (MP), India
Keywords: Anterior capsule opacification, Capsule contraction syndrome, Phimosis, cataract, Intraocular lens and YAG laser

Abstract

Purpose: Aim of this study is to analyze clinical presentation and predisposing risk factors of anterior capsular contraction following phacoemulsification and to assess challenges encountered in management.

Methods: This is retrospective study of anterior capsular contractions of capsulorhexis following phacoemulsification. All patients were analyzed for clinical presentation by detail history and slit lamp examination. YAG laser capsulotomy or surgical excision of phimosis was done and various challenges encountered in management were detailed.

Results: Total 20 patients (23 eyes), age between 26 years 72 years,, with 13 male and female 7 were analyzed retrospectively. The predisposing risk factors noted were Uveitis (7 patients), myopia (3 patients), pseudo exfoliation (2 patients), diabetes (3 patients), trauma (1 patient), both diabetes and uveitis (1patient), Status post phacovitrectomy (1 patient) and no accompaniments in (2 patients). We managed 18 patients (21 eyes) by observation in (3 eyes), YAG laser in (7 eyes), simple surgical excisions in (8 eyes), excision with vitrector (1 eye), aspiration of milky fluid behind IOL from bag (1 eye) and phimosed dislocated bag removal from anterior chamber and intraocular lens (IOL) exchange with (SF) scleral fixated IOL (1eye).

Conclusions: Anterior capsular contraction is more common with patients with various risk factors and has varied clinical presentations. Simple procedures like YAG and surgical excision will help patients to restore vision.

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References

1. Joo CK, Shin JA, Kim JH. Capsular opening contraction after continuous curvilinear capsulorhexis and intraocular lens implantation. J Cataract Refract Surg. 1996 Jun;22(5):585-90. DOI: 10.2147/OPTH.S21791.

2. Davison JA. Capsule contraction syndrome. J Cataract Refract Surg. 1993 Sep;19(5):582-9. [PubMed]

3. Spang KM, Rohrbach JM, Weidle EG. Complete occlusion of the anterior capsular opening after intact capsulorhexis: clinicopathologic correlation. Am J Ophthalmol. 1999 Mar;127(3):343-5. [PubMed]

4. Hayashi K, Hayashi H, Nakao F, Hayashi F. Reduction in the area of the anterior capsule opening after polymethylmethacrylate, silicone, and soft acrylic intraocular lens implantation. Am J Ophthalmol. 1997 Apr;123(4):441-7. [PubMed]

5. Newman DK. Severe capsulorhexis contracture after cataract surgery in myotonic dystrophy. J Cataract Refract Surg. 1998 Oct;24(10):1410-2.

6. Hayashi K, Hayashi H, Nakao F, Hayashi F. Posterior capsule opacification after cataract surgery in patients with diabetes mellitus. Am J Ophthalmol. 2002 Jul;134(1):10-6. [PubMed]

7. Werner L, Pandey SK, Apple DJ, Escobar-Gomez M, McLendon L, Macky TA. Anterior capsule opacification: correlation of pathologic findings with clinical sequelae. Ophthalmology. 2001 Sep;108(9):1675-81. [PubMed]

8. Kato S, Suzuki T, Hayashi Y, Numaga J, Hattori T, Yuguchi T, Kaiya T, Oshika T. Risk factors for contraction of the anterior capsule opening after cataract surgery. J Cataract Refract Surg. 2002 Jan;28(1):109-12. [PubMed]

9. Gimbel HV, Neuhann T. Continuous curvilinear capsulorhexis. J Cataract Refract Surg. 1991 Jan;17(1):110-1. [PubMed]

10. Hanson S, Crandall A, Olson R. Progressive constriction of the anterior capsular opening following intact capsulorhexis. J Cataract Refract Surg. 1993;19:77-82. [PubMed]

11. Masket S. Postoperative complications of capsulorhexis. J Cataract Refract Surg. 1993 Nov;19(6):721-4. [PubMed]

12. Tsinopoulos I, Symeonidis C, Frangou E, Dimitrakos SA. Capsule contraction syndrome in eight cases of hydrophobic one-piece intraocular lens implantation. Clin Exp Optom. 2008 Sep;91(5):469-72. doi: 10.1111/j.1444-0938.2007.00243.x. Epub 2008 Jan 8.

13. Spang KM, Rohrbach JM, Weidle EG. Complete occlusion of the anterior capsular opening after intact capsulorhexis: clinicopathologic correlation. Am J Ophthalmol. 1999 Mar;127(3):343-5 doi: 10.1016/s0002-9394(98)00323-7. [PubMed]

14. Sciscio A, Liu C. Anterior capsular phimosis following Acrysof lens insertion. Br J Ophthalmol. 1999 Aug;83(8):989-90. [PubMed]

15. Ursell PG, Spalton DJ, Pande MV, Hollick EJ, Barman S, Boyce J, Tilling K. Relationship between intraocular lens biomaterials and posterior capsule opacification. J Cataract Refract Surg. 1998 Mar;24(3):352-60.

16. Zambarakji HJ, Rauz S, Reynolds A, Joshi N, Simcock PR, Kinnear PE. Capsulorhexis phymosis following uncomplicated phacoemulsification surgery. Eye (Lond). 1997;11 (Pt 5):635-8.

17. Sugimoto Y, Takayanagi K, Tsuzuki S, Takahashi Y, Akagi Y. Postoperative changes over time in size of anterior capsulorrhexis in phacoemulsification/aspiration. Jpn J Ophthalmol. 1998 Nov-Dec;42(6):495-8.

18. Nishi O. Intercapsular cataract surgery with lens epithelial cell removal. Part II: Effect on prevention of fibrinous reaction. J Cataract Refract Surg. 1989 May;15(3):301-3.

19. Sun R, Gimbel HV. In vitro evaluation of the efficacy of the capsular tension ring for managing zonular dialysis in cataract surgery. Ophthalmic Surg Lasers. 1998 Jun;29(6):502-5. [PubMed]

20. Sudhir RR, Rao SK. Capsulorhexis phimosis in retinitis pigmentosa despite capsular tension ring implantation. J Cataract Refract Surg. 2001 Oct;27(10):1691-4. [PubMed]

21. Yeh PC, Goins KM, Lai WW. Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy. J Cataract Refract Surg. 2002 Feb;28(2):217-20. [PubMed]

22. Gallagher SP, Pavilack MA. Risk factors for anterior capsule contraction syndrome with polypropylene or poly(methyl methacrylate) haptics. J Cataract Refract Surg. 1999 Oct;25(10):1356-61. [PubMed]

23. Gross JG, Kokame GT, Weinberg DV; Dislocated In-The-Bag Intraocular Lens Study Group. In-the-bag intraocular lens dislocation. Am J Ophthalmol. 2004 Apr;137(4):630-5. [PubMed]

24. Jehan FS, Mamalis N, Crandall AS. Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology. 2001 Oct;108(10):1727-31.

25. Tsinopoulos I, Symeonidis C, Frangou E, Dimitrakos SA. Capsule contraction syndrome in eight cases of hydrophobic one-piece intraocular lens implantation. Clin Exp Optom. 2008 Sep;91(5):469-72. doi: 10.1111/j.1444-0938.2007.00243.x. Epub 2008 Jan 8.
Clinical presentation and management of anterior capsular contraction
CITATION
DOI: 10.17511/ijmrr.2016.i09.25
Published: 2016-09-30
How to Cite
1.
Ramnani V, Gupta S, Kumar Ramnani V. Clinical presentation and management of anterior capsular contraction. Int J Med Res Rev [Internet]. 2016Sep.30 [cited 2024Nov.23];4(9):1662-6. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/696
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