Delayed capsular bag distension syndrome

A 61-year-old female with history of cataract surgery 14 years back, presented with complain of diminution of vision in left eye for 10 years and corrected distance visual acuity (CDVA) of 20/800. Slit lamp image and anterior segment optical coherence tomography (AS-OCT) of LE showed collection of fluid behind intraocular lens (IOL) [Fig. 1a-c]. Nd:YAG laser posterior capsulotomy was done to make a central opening [Fig. 1d and e]. The CDVA improved to 20/20 after the intervention.

Figure 1: (a) AS-OCT image at presentation showing fluid accumulation behind the IOL in the capsular bag, (b) Diffuse illumination slit lamp image of the LE showing the white reflex behind the IOL, (c) Slit view image showing the fluid accumulation causing distension of the capsule, (d) Central opening in the posterior capsule with no fluid accumulation after Nd:YAG laser posterior capsulotomy, (e) AS-OCT after Nd:YAG laser posterior capsulotomy showing fluid free clear posterior capsule

In delayed capsular bag distension syndrome (CBDS), there is accumulation of turbid fluid in the capsular bag behind the IOL.[¹²] Nd:YAG laser posterior capsulotomy is a noninvasive safe technique to drain the fluid into the vitreous cavity.

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