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Anterior capsule contraction with foldable silicone intraocular lenses
K F Dahlhauser1, K J Wroblewski, T H Mader
1Madigan Army Medical Center, Tacoma, Washington 98431-5000, USA.
Purpose:
To examine the causes signs, and symptoms of anterior capsule contraction syndrome and the response to neodymium YAG (Nd:YAG) anterior capsulotomy.
Setting:
Madigan Army Medical Center, Tacoma, Washington, USA.
Methods:
This retrospective review comprised 70 cases of phacoemulsification with foldable plate-haptic silicone intraocular lens (IOL) implantation. Patients who developed anterior capsule contraction postoperatively, defined as the anterior capsule being visible through an undilated pupil, had a radial anterior capsulotomy with an Nd:YAG laser. Variables analyzed were visual acuity, subjective complaints, associated inflammation, and IOL decentration.
Results:
Ten eyes of 9 patients (14%) developed anterior capsule contraction and had Nd:YAG laser radial anterior capsulotomy. Three of 9 patients reported decreased visual acuity and glare. Two other patients had chronic anterior chamber inflammation unresponsive to steroids after surgery that resolved after Nd:YAG anterior capsulotomy. Intraocular lens decentration was observed in 3 patients before the Nd:YAG capsulotomy. Posterior lens dislocation occurred in 1 patient after capsulotomy and required surgical lens exchange.
Conclusion:
One-piece foldable silicone IOLs may not provide enough peripheral capsule expansion.