Capsular block syndrome after cataract surgery: clinical analysis and classification

Abstract

Purpose: To study the incidence of and risk factors for postoperative capsular block syndrome (CBS) and propose a new classification based on etiology.

Setting: Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Republic of Korea.

Methods: Charts of 1100 eyes of 990 patients who had phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation between January 2003 and June 2006 were retrospectively reviewed. Demographic data, axial length (AL), type of PC IOL implanted, and intraoperative ophthalmic viscosurgical devices (OVDs) were recorded. The cases of postoperative CBS were collected and the characteristic clinical findings evaluated.

Results: There were 8 cases (7 patients) of postoperative CBS (incidence 0.73%). Longer AL (>or=25.0 mm) was a risk factor for postoperative CBS (P= .008; odds ratio [OR], 5.75, 95% confidence interval [CI], 1.353-24.413). The PC IOL with 4 haptics (Akreos Adapt, Bausch & Lomb) was also associated with an increased incidence of postoperative CBS (P= .001; OR, 7.388; 95% CI, 1.751-31.168). The CBS was classified as noncellular, inflammatory, or fibrotic according to the clinical characteristics.

Conclusions: Although postoperative CBS was a rare complication after cataract surgery, AL and PC IOL design had a significant influence on the incidence. Evaluation of clinical characteristics showed 3 distinct types of CBS.