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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 168

Purse string contracture with complete anterior capsular phimosis: Surgical excision assisted with micro-vitreo retinal blade


1 Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
2 Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
3 Medical Officer and Head, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
4 Chief Medical Officer, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

Date of Web Publication01-Apr-2021

Correspondence Address:
Dr. Prasanna V Ramesh
Mahathma Eye Hospital Private Limited, No.6, Seshapuram, Thennur, Trichy - 620017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3110_20

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How to cite this article:
Ramesh SV, Ramesh PV, Ramesh MK, Rajasekaran R. Purse string contracture with complete anterior capsular phimosis: Surgical excision assisted with micro-vitreo retinal blade. Indian J Ophthalmol Case Rep 2021;1:168

How to cite this URL:
Ramesh SV, Ramesh PV, Ramesh MK, Rajasekaran R. Purse string contracture with complete anterior capsular phimosis: Surgical excision assisted with micro-vitreo retinal blade. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Apr 14];1:168. Available from: https://www.ijoreports.in/text.asp?2021/1/2/168/312405



An 85-year-old female patient presented with cataract, pseudoexfoliation (PXF) and phacodonesis. Uneventful cataract surgery with five mm capsulorhexis and implantation of capsular tension ring (CTR) was performed. After three months, the patient presented with purse-string closure of anterior capsular opening due to phimosis [Figure 1]a with BCVA of 20/400. Surgical excision was done with micro-rhexis forceps and scissors after making a nick with the micro-vitreo retinal blade [Figure 1]b, [Figure 1]c, [Figure 1]d, [Figure 1]e. BCVA improved to 20/20 with a clear central opening [Figure 1]f.
Figure 1: (a) Complete occlusion of anterior capsular opening three months after cataract surgery. (b) Surgical excision of central fibrosis - A nick is made with micro-vitroretinal blade. (c and d) Membranectomy done with micro-rhexis forceps and scissors. (e) Clear red glow seen after excision. (f) Slit-lamp photograph of the same eye taken one week after excision

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PXF is an important risk factor for anterior capsular phimosis.[1],[2] Despite the usage of CTRs which not only enhances bag stability but also prevents contracture, purse-string contracture of anterior capsular opening occurred, in this case, warranting surgical excision.[1]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cheour M, Brour J, Boukari M, Kraiem A. Capsulorhexis contraction syndrome despite capsular tension ring implantation. Bull Soc Belge Ophtalmol 2010;315:19-21.  Back to cited text no. 1
    
2.
Moreno-Montañés J, Sánchez-Tocino H, Rodriguez-Conde R. Complete anterior capsule contraction after phacoemulsification with acrylic intraocular lens and endocapsular ring implantation. J Cataract Refract Surg 2002;28:717-9.  Back to cited text no. 2
    


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