Postoperative Capsular Bag Distension Syndrome: Case Report of an Early Case Following Athalamia due to Vigorous Eye...

Capsular bag distension syndrome (CBDS) is a rare complication of phacoemulsification, characterized by fluid retention in the capsular bag leading to reduced visual acuity, a myopic shift, and a risk of pupillary block.

We report the case of a 65-year-old male who developed CBDS after rubbing his eye vigorously postoperatively. On Postoperative Day 1, his best corrected visual acuity (BCVA) was 0.1 with a myopic shift. We made the diagnosis of CBDS with the Scheimpflug camera and AS-OCT. Conservative management was initially attempted, but due to persistent symptoms, surgical aspiration of the trapped fluid was performed on Day 4. This intervention resulted in BCVA improvement to 0.8 and resolution of the myopic shift.

Differential diagnoses considered included incorrect IOL power, IOL misplacement, transient corneal edema, and incisional astigmatism. We hypothesize that mechanical athalamia due to eye rubbing was an acute trigger leading to forward IOL displacement, adhering it to the anterior capsule and trapping fluid. A stepwise management approach, including observation followed by surgical intervention, proved effective.

CBDS may be precipitated by transient mechanical athalamia following vigorous eye rubbing, which can promote acute intraocular lens-capsular apposition and fluid entrapment. This case highlights the importance of postoperative patient education. Early recognition and management are essential to prevent severe complications such as endophthalmitis and pupillary block.