Cases reported "Syndrome"

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1/20. Capsular block syndrome with external blockage of the capsular opening by a ciliary sulcus fixated posterior chamber lens.

    PURPOSE: To report capsular block syndrome with external blockage of the capsular opening by a posterior chamber lens fixated in the ciliary sulcus. METHOD: Case report. RESULTS: In an 89-year-old man who had undergone cataract surgery, a posterior chamber lens was accidentally fixated in the ciliary sulcus after continuous curvilinear capsulohhexis and phacoemulsification/aspiration. The next day, capsular block syndrome was noted along the posterior chamber lens optic, which was blocking the capsular opening from the outside. CONCLUSION: In all previously reported eyes with capsular block syndrome, the posterior chamber lens had been placed inside the lens capsule to block the continuous curvilinear capsulorhexis opening from the inside.
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ranking = 1
keywords = phacoemulsification
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2/20. Two cases of late postoperative capsular block syndrome.

    Two cases of late postoperative capsular block syndrome that occurred 4 and 8.5 years, respectively, were encountered. One case underwent phacoemulsification after continuous curvilinear capsulorhexis in his left eye. The other case had a can opener type capsulorhexis and underwent extracapsular cataract extraction with trabeculectomy. One-piece posterior chamber lenses were implanted in both cases. Upon slit-lamp examination, the posterior capsules were found distorted posteriorly; the capsular openings were apparently sealed by the lens optic. A whitish material existed between the intraocular lens optic and posterior capsule, with thick aggregation in a lower fifth space in case 1. After Nd:YAG laser anterior capsulotomy in case 1, the thick aggregate spread diffusely on the posterior capsule which was sunken completely for 4 weeks. After Nd:YAG capsulotomy, the distorted posterior capsule disappeared and the best corrected visual acuity was restored to 20/20 in both cases.
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ranking = 1
keywords = phacoemulsification
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3/20. Capsular block syndrome associated with secondary angle-closure glaucoma.

    An 83-year-old man who had phacoemulsification and ciliary sulcus fixation of a posterior chamber intraocular lens developed capsular block syndrome with secondary glaucoma 1 year after surgery. The glaucoma resolved, and vision returned immediately after a neodymium:YAG laser capsulotomy was performed. Capsular block syndrome with secondary angle-closure glaucoma should be considered in pseudophakic patients presenting with increased intraocular pressure and a narrow angle.
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ranking = 1
keywords = phacoemulsification
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4/20. Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy.

    We present a technique, vitrectorhexis, in which a vitrector-cut capsulotomy is used to treat anterior capsule contraction syndrome. A vitrector handpiece is used to remove all fibrous capsule tissue and residual lens epithelial cells from the anterior chamber. Vitrectorhexis may be an alternative to neodymium:YAG laser capsulotomy as it decreases the risk of radial tear extension to the zonules and of secondary IOL decentration. The technique was used in a 77-year-old man with capsulorhexis contraction syndrome and extensive fibrosis after phacoemulsification with silicone piggyback intraocular lens implantation. One day postoperatively, visual acuity improved from 20/60 to 20/30 and the anterior chamber reaction was minimal. At 1 month, best corrected visual acuity was 20/20. The IOL was well centered at 6 months.
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ranking = 1
keywords = phacoemulsification
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5/20. Complete anterior capsule contraction after phacoemulsification with acrylic intraocular lens and endocapsular ring implantation.

    A 69-year-old man with pseudoexfoliation syndrome and bilateral cataract had phacoemulsification with continuous curvilinear capsulorhexis and implantation of a morcher endocapsular ring and AcrySof acrylic intraocular lens (IOL) (Alcon). Two months later, the patient had vision loss in the left eye with a visual acuity of 20/500. He presented with anterior capsule fibrosis in both eyes, with complete occlusion of the capsule opening in the left eye and mild occlusion in the right eye. After a neodymium:YAG laser anterior capsulotomy in the left eye, visual acuity was 20/20. This case shows that endocapsular ring implantation does not prevent anterior capsule contraction syndrome but can prevent IOL decentration.
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ranking = 5
keywords = phacoemulsification
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6/20. Capsular block syndrome associated with horizontal jerk nystagmus.

    A 78-year-old cataract patient with horizontal jerk nystagmus had phacoemulsification and intraocular lens (IOL) implantation in the capsular bag with continuous curvilinear capsulorhexis. One week postoperatively, the posterior capsule ballooned posteriorly, the anterior capsule opening was sealed to the IOL optic, and a transparent liquefied substance accumulated between the lens optic and the posterior capsule. The best corrected visual acuity was 0.6 with a myopic shift compared with the refraction after the first day. A neodymium:YAG laser posterior capsulotomy was performed, and the capsular block syndrome (CBS) resolved. The results confirm the experimental model proposed by Zacharias suggesting that saccadic eye movements contribute to CBS under certain anatomic conditions.
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ranking = 1
keywords = phacoemulsification
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7/20. Intraoperative capsular block syndrome masquerading as expulsive hemorrhage.

    PURPOSE: To describe the clinical features of two cases of intraoperative capsular block syndrome (CBS) mimicking expulsive hemorrhage. SETTING: The Eye Institute at Tan Tock Seng Hospital, National Healthcare Group, singapore. methods: Two case reports. RESULTS: Two patients underwent phacoemulsification under retrobulbar anesthesia and developed severe globe hardening, shallow anterior chamber (AC) and uveal prolapse intraoperatively after hydrodissection. The AC spontaneously deepened in one patient and the operation was converted to extracapsular cataract surgery on suspicion of CBS with posterior capsule rupture, which was confirmed after nucleus expression; anterior vitrectomy was done and an anterior chamber lens implanted. At the eight post-operative month, his best-corrected visual acuity was 6/24 secondary to an epiretinal membrane in the macula. CBS, however, was not recognized in the other patient and caused posterior lens dislocation during attempted phacoemulsification. This patient underwent vitrectomy, removal of the lens nucleus and insertion of a posterior chamber intraocular lens in the sulcus the next day. His best-corrected visual acuity was 6/9 at the tenth postoperative month. CONCLUSIONS: Intraoperative CBS may mimic expulsive hemorrhage. early diagnosis of this condition and proper management optimizes the visual outcome.
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ranking = 2
keywords = phacoemulsification
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8/20. Capsular block syndrome in a case with excessive cortical remnants.

    Ten days after cataract extraction with phacoemulsification and in-the-bag acrylic intraocular lens implantation, capsular block syndrome developed in the right eye of a 62-year-old man. Aspiration of the swollen cortical remnants resulted in resolution of the capsular block.
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ranking = 1
keywords = phacoemulsification
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9/20. Capsular peeling in anterior capsule contraction syndrome: surgical approach and histopathological aspects.

    We present 4 cases of anterior capsule contraction syndrome in which progressive shrinkage of the anterior capsulorhexis developed after uneventful phacoemulsification. Three eyes were pseudophakic, and 1 eye remained aphakic. The newly formed membrane was surgically peeled from the anterior capsule, restoring the capsular bag.
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ranking = 1
keywords = phacoemulsification
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10/20. Management of lens-iris diaphragm retropulsion syndrome during phacoemulsification.

    Lens-iris diaphragm retropulsion syndrome (LIDRS) occurs more often than recognized during small-incision phacoemulsification. This syndrome requires an infusion of fluid into the anterior chamber and is characterized by posterior displacement of the lens-iris diaphragm, marked deepening of the anterior chamber, posterior iris bowing, pupil dilation, and often significant patient discomfort. Using microendoscopy, we have observed that LIDRS is essentially a reverse pupillary block. We describe a surgical technique to mechanically break the iridocapsular block to restore normal chamber depth, relieve patient discomfort, and allow the surgeon to proceed safely with phacoemulsification.
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ranking = 6
keywords = phacoemulsification
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