Purpose:
To describe risk factors and characteristics for capsular distension syndrome following routine small incision cataract surgery.
Methods:
A retrospective analysis of case notes is carried out to identify patients with a clinical diagnosis of capsular distension syndrome (CDS) over a period of 24 months. This diagnosis is based on clinical findings in clinic, ultrasound biomicroscopy, and at Nd:YAG laser capsulotomy. Socio-demographic variables, Visual Acuity (VA), biometric and refractive status were collected.
Results:
In our series 7 patients of mean age 73 years have CDS (6 Caucasian, 1 Asian), 4(57%) males, 3(47%) females. All had routine phacoemulsification with automated irrigation and aspiration, one piece polymethylacrylate IOL was inserted in the capsular bag (6.25 mm optic and an intraocular lens size of 12.5 mm) developed CDS. Pre Laser VA was ≤ 6/36 in 5 (71%). 7 (100%) were preoperatively myopic (spherical equivalent) ranging from -10.1 to -0.25D (mean +/- standard deviation, -3.75 +/- 3.56D). Axial lengths ranged from 22 to 28.27 mm on biometry (mean of 24.5 +/- 1.86). Nd Yag laser treatment carried out at 18 to 37 months (mean +/- standard deviation, 22.7 +/- 6.49 months) post surgery. 7 (100%) achieved VA ≥ 6/12, and clinically CSD has resolved, with no report of complications.
Conclusions:
Myopia and a long axial length is a common risk for the occurrence of CDS in our cohort. Incidence of CDS remains low, but one should consider it in postoperative refractive surprise. Nd-Yag Laser is an effective modality to reverse this condition safely.
Keywords: small incision cataract surgery • clinical (human) or epidemiologic studies: risk factor assessment • cataract