Anterior Capsular Contraction Syndrome in Cataract Surgery: A Review of Challenges and Solutions

In the era of refractive surgery, the primary goal of cataract surgery has evolved from merely restoring vision to ensuring optimal visual outcomes. Advances in surgical precision, standardization, intraocular lens manufacturing, accurate intraocular lens power selection, and postoperative visual quality measures have significantly enhanced visual acuity after cataract surgery. Capsule contraction syndrome (CCS) is characterized by capsular wrinkling and fibrosis, resulting in a decreased equatorial diameter of the capsular bag, decentration, and tilt of the intraocular lens. While CCS is an uncommon complication, its potential effect on vision requires attention from clinicians. This syndrome is caused by the proliferation and fibrosis of lens epithelial cells, leading to shrinkage of the capsule and contraction of the capsulorhexis opening, with the anterior lens capsule becoming thicker and cloudier, impacting visual outcomes and patient satisfaction. With continued research and advancements, the goal is to minimize the occurrence of CCS and optimize visual results for patients undergoing cataract surgery. In this study, we delve into the forefront of CCS research, analyzing its clinical manifestations, etiological factors, influential determinants, mechanistic pathways, preventative strategies, and therapeutic interventions. By understanding CCS and identifying its contributing factors, we can enhance our ability to effectively predict and manage this complication.