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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 853

Severe anterior capsular phimosis with lens decentration in a patient with high myopia


Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India

Date of Web Publication16-Jul-2022

Correspondence Address:
Dr. Amit K Deb
Associate Professor of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry - 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_441_22

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How to cite this article:
Sarkar S, Deb AK, Ramanathan P, Jossy A, Patel M. Severe anterior capsular phimosis with lens decentration in a patient with high myopia. Indian J Ophthalmol Case Rep 2022;2:853

How to cite this URL:
Sarkar S, Deb AK, Ramanathan P, Jossy A, Patel M. Severe anterior capsular phimosis with lens decentration in a patient with high myopia. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Aug 19];2:853. Available from: https://www.ijoreports.in/text.asp?2022/2/3/853/351191



Capsular contraction syndrome (CCS) occurs predominantly after continuous curvilinear capsulorhexis.[1] It can lead to capsulorhexis shrinkage and secondary intraocular lens (IOL) deformation or decentration. CCS is seen in pseudoexfoliation, diabetic retinopathy, myotonic dystrophy, retinitis pigmentosa, uveitis, high myopia, etc.[1],[2],[3],[4],[5]

A 42-year-old woman with pathological myopia presented with progressive loss of vision in both eyes for 6 months after uneventful phacoemulsification 2 years ago. Best-corrected visual acuity (BCVA) was 2/60 in OD and 6/36 in OS. Slit-lamp examination revealed severe degree of anterior capsular phimosis with IOL deformation and decentration in OD [Figure 1]a and mild anterior capsular phimosis in OS [Figure 1]b. The IOL-bag complex was explanted due to zonular instability followed by pars plana vitrectomy with 360° prophylactic barrage endolaser in OD. The patient was left aphakic [Figure 2]a. Nd: YAG laser capsulotomy was performed in OS [Figure 2]b. One week following surgery, BCVA improved to 6/9 with -2 D spherical correction in OD and 6/9 in OS.
Figure 1: (a) Severe contracted anterior capsule with closed capsulorhexis opening, IOL haptics folded over the optic with severe deformity and IOL decentration, fused anterior and posterior capsules inferiorly, stretched zonules, and membranous posterior capsular opacification (PCO) in the right eye; (b) mild anterior capsular opacity (ACO) but an intact anterior capsular opening, mild PCO, and mild IOL deformity in the superotemporal aspect in the left eye

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Figure 2: Slit-lamp photograph showing (a) aphakia in the right eye following explantation of IOL-capsular bag complex; (b) clear visual axis in the left eye 1 week after Nd: YAG laser capsulotomy

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Statement of ethics

Written informed consent for publication (including the images) has been obtained from the parent of the patient. All procedures carried out were in accordance with the tenets of the Declaration of Helsinki. Institute Ethics Committee approval is not required for a case report according to Indian Council of Medical Research guidelines.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Zhang Z-D, Song Z, Chen D, Huang F. Bilateral capsule contraction syndrome following pathological myopic cataract surgeries. Int J Ophthalmol 2012;5:406-8.  Back to cited text no. 1
    
2.
Naik M, Sethi H, Mehta A. Capsular bag phimosis. Am J Ophthalmol Case Rep 2020;20:100999. doi: 10.1016/j.ajoc.2020.100999.  Back to cited text no. 2
    
3.
Gul A, Altintas K, Dal D, Simsek S. Significant intraocular lens folding due to severe capsular contraction. Jpn J Ophthalmol 2008;52:134-6.  Back to cited text no. 3
    
4.
Wong Jr WK, Ing MR, Ling CJ. Complete anterior capsule phimosis following cataract surgery in a patient with a history of retinopathy of prematurity, nystagmus, and a narrow angle. Case Rep Ophthalmol 2019;10:274-80.  Back to cited text no. 4
    
5.
Al-Kharashi SA, Al-Obailan M. Capsular phimosis with complete occlusion of the anterior capsular opening after intact continuous curvilinear capsulorrhexis. Saudi J Ophthalmol 2009;23:175-8.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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