Capsular bag distension after endophacoemulsification and posterior chamber intraocular lens implantation

Six cases of capsular bag distension after capsulorhexis, endophacoemulsification, and posterior chamber intraocular lens (IOL) implantation are presented. Five cases had prominent posterior subcapsular cataracts preoperatively. In three cases, the anterior chamber depths were shallower and the apparent refractive errors were more myopic than normal after surgery. All six cases exhibited an apparent early complete sealing of the anterior capsular remnant against the anterior IOL optic. In each case, the capsular bag contained moderate particulate debris and flare while the adjacent vitreous and anterior chambers were clear. I suspect the particles are epithelial cell and cortical debris suspended in a fluid comprising lens epithelial protein, cellular breakdown products, balanced salt solution, and water. Five cases have received no specific treatment. In one case, a neodymium:YAG laser anterior capsulotomy allowed a forward egress of fluid from the distended capsular bag and a return to normal pseudophakic anatomy.