Anterior Capsulotomy For Early Post-Operative Capsular Block Syndrome – A Sequential Imaging Approach With Anterior Segment Ss-Oct

Early post-operative capsular block syndrome is a rare complication of cataract surgery. We aim to describe its clinical and serial imaging characteristics, through high-definition anterior segment OCT (AS-OCT).

Department of Ophthalmology, Unidade Local de Saúde de Gaia e Espinho.

A 65-year-old woman underwent cataract surgery. Poor pupillary dilation (5mm) was noted and the surgeon opted for a high-density cohesive-dispersive viscoelastic to induce viscomydriasis. The capsulorhexis was performed near the pupillary margin and an intraocular lens (IOL) targeted to emmetropia was implanted. On post-operative day 1, the patient complained of reduced distance visual acuity. Refraction was -2.50-1.00x70; anterior chamber depth (ACD) was reduced and the edge of the capsulorhexis overlayed the edge of the IOL, which was separated from the posterior capsule by a transparent liquid. Since there was no improvement over following 5 days, an anterior capsulotomy was performed, which resulted in an ACD increase and less separation between the IOL and the posterior capsule; 1 hour later refraction was -0.50-1.50x70. Serial AS-OCT confirmed the clinical diagnosis and depicted changes in anatomical relationship between referred structures.

Early post-operative capsular block syndrome is a rare (<1% of cases) complication of cataract surgery. Anterior capsulotomy is a safe option when preservation of the posterior capsule is advisable. Serial imaging with AS-OCT confirms the diagnosis and treatment success.