[Complete occlusion of the capsulorhexis incision by anterior capsule shrinkage]

Abstract

The capsulorhexis technique has become established as procedure of choice for anterior capsular opening in cataract surgery. With the spread of the method even relatively rare complications are gaining in importance.

Case: In a patient with cataract and multifocal chorioretinitis, phacoemulsification with implantation of a one-piece PMMA posterior chamber IOL through a capsulorhexis opening was performed without complications. Within a period of 3 months, shrinking of the anterior capsule led to complete occlusion of the anterior aperture. To our knowledge, no comparably severe finding has been reported. The anterior capsule was successfully opened by by means of Nd:YAG laser capsulotomy. However, improvement in visual acuity was limited by cystoid macular edema due to the basic condition.

Conclusion: No relations with other systemic or eye diseases have yet been demonstrated. As another case report describes a similar--though less severe--combination of progressive constriction of the anterior capsule and inflammatory eye disease, the opening of the anterior capsule in such cases should be sufficiently large. If anterior capsular shrinkage has developed, Nd:YAG-laser capsulotomy is a low-risk method of therapy.