Saraswathy, Bala; Narendran, Kalpana
Department of Cataract Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
Address for correspondence: Dr. Bala Saraswathy, Aravind Eye Hospital, Civil Aerodrome Post, Sitra, Coimbatore, Tamil Nadu - 641 014, India. E-mail: [email protected]
Received March 26, 2022
Received in revised form October 09, 2022
Accepted October 20, 2022
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A 56-year-old male presented with defective vision in both eyes for 6 months. He is known case of diabetes for 7 years, history of left eye cataract surgery 5 years back, retinal surgery for proliferative diabetic retinopathy 4 years back and history of Yag capsulotomy in left eye 2 years back for posterior capsular opacification (PCO). Vision in right eye is 6/12 and left eye 6/24. On examination, right eye showed lens changes, and left eye showed pseudophakia with well-circumscribed Yag opening in the centre [Figure 1a] with opacified white fibrotic matter on the anterior hyaloid phase covering the yag opening [Figure 1b]. Both eye fundi showed stable proliferative diabetic retinopathy. Repeat yag capsulotomy enlargement with hyaloidotomy was done, and the vision is improved to 6/9.
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Figure 1: (a) Well-circumscribed clear yag opening in retroillumination (white arrows). (b) Whitish membrane on anterior hyaloid phase blocking the yag opening on diffuse illumination due to LEC migration
Recurrence of after cataract (PCO) is very rare occurrence after Nd-Yag capsulotomy with large opening.[1] Postoperative inflammation causes elevated cytokines which leads to lens epithelial cell (LEC) proliferation beyond the margin of capsulorhexis.[2] LECs can also proliferate along intact anterior hyaloid phase.[3] Most common cause for recurrent PCO is post-vitrectomized eyes undergoing cataract surgery especially for diabetic retinopathy, complicated cataract and myotonic dystrophy.[2,4] Treatment includes repeat Nd-yag capsulotomy and Nd-yag anterior hyaloidotomy if PCO proliferates along the anterior hyaloid phase. So in such patients should explain the possibility of recurrent PCO.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patients understand that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
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