ESCRS - POCAT199 - Capsular Bag Distension Syndrome (Cbds) With Myopic Shift Following Cataract Surgery In Hyperopic Eyes With Narrow Pupil Size

Capsular Bag Distension Syndrome (Cbds) With Myopic Shift Following Cataract Surgery In Hyperopic Eyes With Narrow Pupil Size

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT199 | Type: Free paper | DOI: 10.82333/twqw-ah04

Authors: Dr Florian Rüfer* 1 , Dr Detlef Holland 1

1AugenzentrumONE,Kiel,Germany

Purpose

In a case series of four eyes with unexpected myopic shift of −3.0 D (target refraction emmetropia), capsular bag distension syndrome (CBDS) was observed after uncomplicated cataract surgery and treated with posterior Nd:YAG capsulotomy. A risk factor analysis focusing on biometric and surgical parameters was performed.

Setting

Single Surgeon Case Series

Methods

Four eyes of four patients (mean age 75.3 ± 3.3 years) were included. Before and after cataract surgery, spherical equivalent (SE) was measured using an autorefractor (Nidek ARK-1s). Anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were assessed with the IOLMaster 700. Photopic, mesopic, and scotopic pupil diameters were measured using a Scheimpflug camera (Sirius, Schwind). Posterior capsule configuration was imaged with the IOLMaster 700. After missing regression of the CBDS, therapeutic Nd:YAG posterior capsulotomy was performed and all parameters were reassessed during follow-up.

Results

Preoperatively (mean ± SD), SE was +2.63 ± 0.5 D, photopic pupil diameter 2.1 ± 0.2 mm, ACD 2.3 ± 0.1 mm, LT 5.1 ± 0.1 mm, and AL 21.8 ± 0.2 mm. All eyes underwent uncomplicated phacoemulsification with implantation of a single-piece IOL (Rayner RayOne) into the capsular bag. Slit-lamp examination revealed a centered IOL within the capsular bag, which appeared markedly distended posteriorly. Postoperatively, SE was −3.7 ± 0.9 D and ACD 3.1 ± 0.7 mm. As the myopic shift showed no tendency toward regression, posterior Nd:YAG capsulotomy was performed 7, 9, 15, and 45 days after surgery, respectively. Subsequently, SE returned towards emmetropia (mean −0.25 ± 0.8 D), and ACD increased to 3.8 ± 0.4 mm. 

Conclusions

Identified risk factors for the underlying CBDS included a shallow anterior chamber, small pupil size, and the use of a cohesive ophthalmic viscosurgical device. In all cases, posterior Nd:YAG capsulotomy resulted in anatomical and refractive normalization.