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Complete resolution of hyperopic shift in anterior capsular contraction syndrome after Nd:YAG laser capsulotomy: a case report

  • Intifada ,
  • Indri Wahyuni ,
  • Dicky Hermawan ,


Abstract

Link of Video Abstract: https://youtu.be/UfCbUNzPIRE

 

Background: Anterior capsular contraction syndrome (ACCS) is a disorder in which the anterior capsulectomy opening shrinks excessively. One of the many factors that have been discovered to aggravate the problem is a lack of zonular support for the lens capsule. The prognosis for non-progression of contractions after Nd:YAG anterior capsulotomy is quite excellent. This study aims to present a complete resolution of the hyperopic shift in an anterior capsular contraction syndrome (ACCS), a rare complication of cataract surgery.

Case Illustration: This case report presented a 63-year-old female who developed ACCS in the right eye two years after uncomplicated cataract surgery and intraocular lens implantation. A moderate hyperopic shift of +3.00 D was noted in the affected eye at the initial presentation. Slit-lamp examination revealed an anterior capsule opacification and anterior capsular contraction with fibrosis surrounding the capsulorhexis opening. Ocular and systemic past medical history was unremarkable, and no known risk factors associated with contraction syndrome were found. Nd:YAG laser capsulotomy with six relaxing incisions was performed to release the anterior capsular contraction. Two weeks following capsulotomy, the patient’s visual acuity remarkably improved to LogMAR 0.00 without correction. The hyperopia was completely resolved, and a decrease in anterior chamber depth compared to pre-capsulotomy measurement was noted. ACCS is a possible complication following capsulorrhexis performed in uneventful cataract surgery, which may occur in patients with no known ocular or systemic risk factors. ACCS is commonly asymptomatic, and hyperopic shift is a rare manifestation of ACCS. The backward shift of the intraocular lens (IOL) induces hyperopia due to the anterior capsule contraction. The preferred treatment for ACCS is relaxing incisions using Nd:YAG laser capsulotomy.

Conclusion: Hyperopic shift in ACCS is a rare complication of cataract surgery. However, prompt treatment of contraction release with Nd:YAG laser capsulotomy effectively restored visual function.

Keywords: anterior capsular contraction syndrome capsulorhexis laser capsulotomy

References

  1. Kocak Altintas AG. Capsule Contraction Syndrome: Incidence, Pathogenesis, Prevention and Treatment Alternatives. Trends in Ophthalmology Open Access Journal. 2019 Feb 7;2(2).
  2. Davison JA. Capsule contraction syndrome. J Cataract Refract Surg. 1993 Sep;19(5):582–9.
  3. Macky TA, Pandey SK, Werner L, Trivedi RH, Izak AM, Apple DJ. Anterior Capsule Opacification. Int Ophthalmol Clin. 2001;41(3):17–31.
  4. Ye H, Zhang J, Qian Y. Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Journal of International Medical Research. 2018 Sep 19;46(9):3692–7.
  5. Alintaş AGK, Dal D. Capsule contraction syndrome in Behcet’s disease. Int J Ophthalmol. 2010;3(4):358–60.
  6. Jick SL, Beardsley TL, Brasington CR, Buznego C, Grostern RJ, Park L, et al. Complications of Cataract Surgery. In: Basic and Clinical Science Course: Lens and Cataract. 2019th–2020th ed. San Francisco: American Academy of Ophthalmology; 2020. p. 155–93.
  7. Ramnani DV, Gupta DS, Kumar Ramnani DV. Clinical presentation and management of anterior capsular contraction. International Journal of Medical Research and Review. 2016 Sep 30;4(9):1662–6.
  8. Nishi O, Nishi K. Intraocular lens encapsulation by shrinkage of the capsulorhexis opening. J Cataract Refract Surg. 1993 Jul;19(4):544–5.
  9. Zhang K, Zhu X, Chen M, Sun X, Yang J, Zhou P, et al. Elevated Transforming Growth Factor- β 2 in the Aqueous Humor: A Possible Explanation for High Rate of Capsular Contraction Syndrome in High Myopia. J Ophthalmol. 2016;2016:1–6.
  10. Brilliyanto FS, Suhendro G, Wahyuni I, Rochmanti M, Pramono W. Metformin Reduced Collagen Deposition and Contractility, but Increased Collagen Degradation in in vitro Posterior Capsule Opacification Model. Indonesian Biomedical Journal. 2021;13(2):186–91.
  11. Erkasan Sitorus T, Mustika A, Basuki Notobroto H, Hermawan D, Komaratih E. Attenuation of Transforming Growth Factor-? Expression by Alteplase in Anterior Lens Capsule Fibrosis Model with Fibrin Reaction In Vitro. International Journal of Research Publications. 2021 Jul 16;82(1).
  12. Tsinopoulos IT, Tsaousis KT, Kymionis GD, Symeonidis C, Grentzelos MA, Diakonis VF, et al. Comparison of anterior capsule contraction between hydrophobic and hydrophilic intraocular lens models. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2010 Aug 23;248(8):1155–8.
  13. 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.
  14. Sacu S, Menapace R, Findl O. Effect of Optic Material and Haptic Design on Anterior Capsule Opacification and Capsulorrhexis Contraction. Am J Ophthalmol. 2006 Mar;141(3):488-493.e2.
  15. Chang PY, Chang SW. Rapid anterior capsular phimosis after cataract surgery in a patient with chronic angle closure glaucoma. Taiwan J Ophthalmol. 2015 Dec;5(4):192–4.
  16. Kim TG, Moon SW. Hyperopic shift caused by capsule contraction syndrome after microincision foldable intraocular Lens implantation: case series. BMC Ophthalmol. 2019 Dec 20;19(1):116.
  17. Qatarneh D, Hau S, Tuft S. Hyperopic Shift From Posterior Migration of Hydrophilic Acrylic Intraocular Lens Optic. J Cataract Refract Surg. 2010 Jan;36(1):161–3.
  18. Oh SH, Park JY, Yim H Bin, Lee NY. Anterior vaulting of single piece in-the-bag intraocular lens after blunt trauma. J Optom. 2012 Jan;5(1):6–8.
  19. Eldin AEMT. Refractive change after YAG laser anterior capsulotomy in capsular phimosis syndrome. Journal of American Science. 2014;10(8):199–201.
  20. Wilde C, Ross A, Awad M, Chen HC, Dua HS. Management of anterior capsular contraction syndrome: pitfall of circular capsulotomy technique with the neodymium YAG laser. Eye. 2018 Sep 18;32(9):1546–8.
  21. Xu D, Wu H, Zhang L. Application of capsular bag relaxation for capsular contraction syndrome. Exp Ther Med. 2020 May 19;20(2):1115–20.
  22. Wong Jr. WK, Ing MR, Ling CJM. Complete Anterior Capsule Phimosis following Cataract Surgery in a Patient with a History of Retinopathy of Prematurity, Nystagmus, and a Narrow Angle. Case Rep Ophthalmol. 2019 Aug 13;10(2):274–80.
  23. Al-Kharashi SA, Al-Obailan M. Capsular phimosis with complete occlusion of the anterior capsular opening after intact continuous curvilinear capsulorrhexis. Saudi Journal of Ophthalmology. 2009 Jul;23(2):175–8.
  24. Sari N, Salim F, Sara M, Fitri EW, Bulqiah M. Efficacy of 1064nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser and 2940nm fractional erbium laser for severe acne with acne scar: a case report. Bali Med J. [Internet]. 2023 May 23 [cited 2023 Sep. 12];12(2):1676-9. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/4107.

How to Cite

Intifada, Indri Wahyuni, & Hermawan, D. . (2023). Complete resolution of hyperopic shift in anterior capsular contraction syndrome after Nd:YAG laser capsulotomy: a case report. Bali Medical Journal, 12(3), 2748–2751. https://doi.org/10.15562/bmj.v12i3.4780
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