Purpose:
to study the characteristics of late-onset capsular block syndrome (CBS) using swept-source anterior-segment OCT (AS-OCT), before and after neodymium: YAG (Nd:YAG) laser posterior capsulotomy (YPC).
Methods:
4 cases of late-onset CBS were identified during routine slit lamp examination. A complete ophthalmological evaluation was performed before and one month after YPC, including slit lamp photography and AS-OCT (CASIA OCT®, Tomey Co., Japan). Diameter of the anterior capsulorhexis and the distance between IOL anterior surface and endothelium were measured from AS-OCT scans. Pre- and post-YPC measurements were compared by paired t-test. Topical 0.2% dexamethasone was administered for two weeks after YPC.
Results:
Table 1 shows clinical data. Slowly progressive decrease in visual acuity, without any myopic or hypermetropic shift was observed in all cases. Slit lamp examination showed accumulation of a milky-white liquefied substance between the IOL and the posterior capsule. This milky substance was moderately hyper-reflecting upon AS-OCT examination. Cortical remnants could be identified behind the IOL optics, and the capsular bag appeared distended towards the vitreous cavity. The diameter of the anterior capsulorhexis was smaller than the IOL optics in all cases (mean=4.4mm, range=2.7 to 5.5mm). Following YPC, best-corrected visual acuity improved in all patients (p<0.001), without complications. Both IOL position and refraction did not encounter significant modifications with YPC (p=0.14). Figure 1 reports pre- and post-YPC slit lamp and AS-OCT images of case 3.
Conclusions:
AS-OCT allowed accurate imaging and measurement of anterior segment parameters in late-onset CBS. YPC was an effective and safe therapy in these four CBS cases.$$$$graphic_{C5252D62-64C7-4E7B-BAC1-658B4C85B74F}$$ $$graphic_{A44FF7A3-2E42-4B7A-892B-EFEB9BF7C41A}$$
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • cataract • laser