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Case Reports
. 2019 Aug 13;10(2):274-280.
doi: 10.1159/000502282. eCollection 2019 May-Aug.

Complete Anterior Capsule Phimosis following Cataract Surgery in a Patient with a History of Retinopathy of Prematurity, Nystagmus, and a Narrow Angle

William K Wong Jr  1   2 , Malcolm R Ing  1   2 , Carlthan J M Ling  3
Affiliations
Case Reports

Complete Anterior Capsule Phimosis following Cataract Surgery in a Patient with a History of Retinopathy of Prematurity, Nystagmus, and a Narrow Angle

William K Wong Jr et al. Case Rep Ophthalmol. .

Abstract

The authors present a case of complete anterior capsule phimosis and vision decline which developed 4 weeks postoperatively in the right eye after uncomplicated cataract surgery. Prior ocular history included retinopathy of prematurity in both eyes, acute angle closure glaucoma in the left eye, prophylactic laser peripheral iridotomy for a narrow angle in the right eye, and nystagmus in both eyes. This condition was addressed by surgically releasing the anterior capsule with microscissors to open the pupillary space which had been completely obscured by the anterior capsule, also causing the haptics of the 1-piece intraocular lens to deform. When cataract surgery was performed on his left eye, the surgeon performed prophylactic relaxing incisions at 4 points on the capsular opening. It is notable that his left eye did not develop anterior capsule phimosis postoperatively.

Keywords: Anterior capsule phimosis; Capsular contraction syndrome; Complete occlusion of the capsular opening; Occluded pupil; Retinopathy of prematurity.

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Conflict of interest statement

None of the authors have any conflicts of interest.

Figures

Fig. 1
Fig. 1
Complete anterior capsule phimosis with haptics constricted in visual axis.
Fig. 2
Fig. 2
Postoperative view following capsulotomy with removal of the haptics.
Fig. 3
Fig. 3
Excisional biopsied specimen showed anterior capsule with proliferating metaplastic lens epithelial cells, fibroblastic changes, and contractile elements. a Histopathological section shows the anterior capsule (shown between arrows) stained magenta (periodic acid-Schiff, original magnification ×400). Immunohistochemical staining was diffusely positive to smooth muscle actin (stained brown) (b) and focally positive to cytokeratin AE1/AE3 (stained brown) (c), both markers for myofibroblasts and epithelium (original magnification ×400). d Histopathological section showed fibroblastic changes staining extracellular collagen blue (broken arrow) and nuclei dark blue (long solid arrow). The anterior capsule (short solid arrows) is again pictured on the right side of the frame and stained blue (Masson's trichrome, original magnification ×400).
See this image and copyright information in PMC

References

    1. Gimbel HV, DeBroff BM. Intraocular lens optic capture. J Cataract Refract Surg. 2004 Jan;30((1)):200–206. - PubMed
    1. Gimbel H, DeBroff B. Intraocular lens optic capture. Journal of Cataract & Refractive Surgery. 2004 Jan;30(1):200-6. Hayashi H, Hayashi K, Nakao F, Hayashi F. Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome. Br J Ophthalmol. 1998 Dec;82((12)):1429–32. - PMC - PubMed
    1. Lüke C, Dietlein TS, Jacobi PC, Konen W, Krieglstein GK. Massive anterior capsule shrinkage after plate-haptic silicone lens implantation in uveitis. J Cataract Refract Surg. 2001 Feb;27((2)):333–6. - PubMed
    1. Hayashi K, Hayashi H, Matsuo K, Nakao F, Hayashi F. Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa. Ophthalmology. 1998 Jul;105((7)):1239–43. - PubMed
    1. Hayashi H, Hayashi K, Nakao F, Hayashi F. Area reduction in the anterior capsule opening in eyes of diabetes mellitus patients. J Cataract Refract Surg. 1998 Aug;24((8)):1105–10. - PubMed

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