POSTERIOR CAPSULAR OPACIFICATION VS INTRAOCULAR LENS OPACIFICATION

To make a pictorial review of lacteocrumenasia including  images of AS-OCT, ocular ultrasound, and real time videos showing the typical leakage of material during capsulotomy. We give the diagnostic clues to recognize and perform a correct differential diagnosis of this pathology.

We present three cases of lacteocrumenasia from patients over 70 years seen between September and October of 2023 in our hospital. One of the patients was referred to our center with the wrong diagnosis of intraocular lens opacification.

In the three cases we performed AS-OCT and slit lamp examination after pharmacological mydriasis. In one patient ocular ultrasound was also performed. Each of these tests was performed before and after posterior Nd:YAG capsulotomy. Real time videos during capsulotomy were taken.

In the three cases, leakage of milky fluid during capsulotomy was demonstrated in the videos. Thickening of the space between posterior side of the lens and posterior capsule was detected in us and AS-OCT. Treatment with Nd:YAG capsulotomy was performed  in the three cases. All of them showed a clear improvement in visual acuity after treatment.

Lacteocrumenasia is a benign entity that can occur several years after cataract surgery. It consists on aseptic material deposit between the posterior side of the lens and the posterior capsule, that can be seen in a simple slit lamp examination. If necessary, AS-OCT and ultrasound can also be done, to confirm this typical finding. This allows differentiate lacteocrumenasia from intraocular lens opacification. In this work we show how careful visualization of the lens during capsulotomy allows to confirm the diagnosis.