A Case of Late-onset Capsular Block Syndrome, Resulting in the Misdiagnosis of Intraocular Lens Opacity

Min Won Ahn; So Hee Kim; Jong Soo Lee

doi:10.3341/jkos.2018.59.6.589

Journal List > J Korean Ophthalmol Soc > v.59(6) > 1096601

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Ahn, Kim, and Lee: A Case of Late-onset Capsular Block Syndrome, Resulting in the Misdiagnosis of Intraocular Lens Opacity

Case Report

Journal of the Korean Ophthalmological Society 2018; 59(6): 589-593.

Published online: 15 June 2018

DOI: https://doi.org/10.3341/jkos.2018.59.6.589

A Case of Late-onset Capsular Block Syndrome, Resulting in the Misdiagnosis of Intraocular Lens Opacity

Min Won Ahn, MD, So Hee Kim, MD, Jong Soo Lee, MD, PhD

Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Address reprint requests to Jong Soo Lee, MD, PhD. Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 49241, Korea. Tel: 82-51-240-7321, Fax: 82-51-242-7341, jongsool@pusan.ac.kr

Received 8 February 2018 Revised 29 March 2018 Accepted 25 May 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of late-onset capsular block syndrome, which resulted in a misdiagnosis of intraocular lens (IOL) opacity.

Case summary

A 59-year-old man visited our clinic with reduced visual acuity in the right eye from 1 year prior. He had undergone uncomplicated bilateral cataract surgery by phacoemulsification with IOL implants at another hospital 10 years before. There was no specific history with the exception of hypertension. After being diagnosed in the ophthalmology clinic with IOL degeneration and opacity in the right eye, he was referred to our hospital for IOL replacement. Upon examination, his right uncorrected visual acuity was 0.06 and intraocular pressure was 22 mmHg. The refractive error could not be checked due to IOL opacity. Slit-lamp microscopy revealed a cloudy, milky IOL. Anterior-segment optical coherence tomography of the right eye showed retention of a highly reflective material in the lens capsule behind the IOL. Posterior capsule enlargement of the right eye was confirmed on ultrasound biomicroscopy. After neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy was performed, the homogeneous space disappeared and the eye recovered normal visual acuity.

Conclusions

Capsular block syndrome is a rare complication that can occur shortly (1 day to 2 days) after cataract surgery. Late-onset capsular block syndrome, which occurs 10 years after surgery differs from typical clinical manifestations. Thus, capsular block syndrome is an important consideration upon the presentation of opacification due to IOL degeneration.

Keywords: Capsular block syndrome, Intraocular lens opacification, Misdiagnosis, Neodymium-doped yttrium aluminium garnet (Nd:YAG) laser

Figures and Tables

Figure 1

Slit lamp photography of the right eye. (A) The anterior capsular incision was fibrous and adhered to the optic part of intraocular lens (IOL), cloudy milky material was observed in the intraocular lens space behind the IOL. And the posterior capsule was swollen. (B) After the neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy, milky white material was not observed behind the intraocular lens space and the uncorrected visual acuity was 1.0.

Figure 2

Anterior optical coherence tomography and ultrasound biomicroscopy. (A) Anterior segment optical coherence tomography of the right eye showed retention of highly reflective material in the lense capsule behind the intraocular lens. Arrow showed Retention of highly reflective material in the capular bag. (B) Posterior capsule enlargement of right eye was confirmed on ultrasound biomicroscopy. Arrow showed capsular bag distension. IR = infrared; ART = automatic real-time tracking; OCT = optical coherence tomography; HR = high resolution.

Notes

This study was supported by a grant from University Research Park Project of Busan National University funded by Busan Institute of S&T Evaluation and Planning (No.201726550002).

^{Conflicts of Interest} The authors have no conflicts to disclose.

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