A 78-year-old White man was referred to our clinic for evaluation of an unexplained subjective decrease in vision for more than 6 months, more pronounced in the right eye, and insufficiently controlled intraocular pressure (IOP). Local antiglaucoma therapy with a fixed-combination prostaglandin and β-blocker was used regularly in both eyes owing to long-standing primary open-angle glaucoma. Uneventful cataract surgery with phacoemulsification and in-the-bag insertion of an intraocular lens was performed 10 years earlier in both eyes. Best corrected visual acuity (BCVA) was 1.0 and 0.5 (Snellen equivalent, 20/20 and 20/40) OD and OS, respectively. His manifest refraction revealed a difference of −0.75 D sphere compared with his own preexisting glasses in the right eye. IOP was 24 mm Hg in the right eye and 18 mm Hg in the left eye.
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Late-onset postoperative capsular bag distension syndrome
C. Perform YAG capsulotomy
Postoperative capsular bag distension syndrome (CBDS) describes a rare complication of cataract surgery with an incidence of 0.73%, in which opaque fluid accumulates in the retrolental space between the artificial lens and the capsular bag after cataract surgery with intraocular lens placement and intact posterior capsule.1,2 Different variants of CBDS have been classified, according to time of onset (intraoperative, early postoperative, and late postoperative)2 or underlying pathomechanisms (noncellular, inflammatory, fibrotic).1
The early-onset variant occurs between 1 day and 2 weeks postoperatively by unknown cause, whereas the late-onset or fibrotic variant has been described on average 3.8 years after uneventful cataract surgery3 and is expected to be caused by lens epithelial cell proliferation and pseudometaplasia.1,2 Large amounts of α and β crystalline have been isolated from the retrolental milky substance.4
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Thomas Falb, MD, Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria (email@example.com).
Published Online: May 26, 2022. doi:10.1001/jamaophthalmol.2022.0641
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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