Kalliath Jay, Prakash Gaurav, Avadhani Kavitha, Shakuntala Anitha
NMC Eye Care, New Medical Centre Specialty Hospital, Abu Dhabi, United Arab Emirates.
Saudi J Ophthalmol. 2016 Oct-Dec;30(4):264-267. doi: 10.1016/j.sjopt.2016.11.002. Epub 2016 Nov 10.
Posterior capsular opacification (PCO) is common after cataract surgery. Recurrence is very rare after a successful Yttrium aluminium-garnet (YAG) capsulotomy in adults. We report a case of visual axis re-opacification after a successful YAG capsulotomy for PCO in an adult. A 60-year male underwent phacoemulsification with +20.0 D acrylic hydrophobic intraocular lens implantation and silicon oil removal (SOR) five months after a successful retinal detachment repair. He underwent a capsulotomy after two months of surgery; however, the visual axis re-opacified after three more months. A YAG anterior hyaloidotomy resulted into improved vision which was maintained over further follow-up. In a post-vitrectomy pseudophakic eye, compression by silicon oil on the posterior capsule is lost after SOR, causing easier and faster migration of lens epithelial cells from the equator to the centre forming an early PCO. Recurrence is possible due to the proliferation of lens epithelial cells along anterior hyaloid also. This case highlights the infrequent scenario of visual axis re-opacification and therefore has teaching value for residents and trainee doctors, who should be made aware of this occurrence. Patients should be explained about this possibility when undergoing YAG capsulotomy in complicated cases such as this one.
白内障手术后后囊膜混浊（PCO）很常见。在成人中，成功进行钇铝石榴石（YAG）晶状体囊切开术后复发非常罕见。我们报告一例成人成功进行YAG晶状体囊切开术治疗PCO后视轴再次混浊的病例。一名60岁男性在视网膜脱离修复成功五个月后接受了超声乳化手术，并植入了+20.0 D丙烯酸疏水人工晶状体，同时进行了硅油取出术（SOR）。术后两个月他接受了晶状体囊切开术；然而，三个月后视轴再次混浊。YAG前玻璃体膜切开术使视力得到改善，并在进一步随访中得以维持。在玻璃体切除术后的假晶状体眼中，硅油取出术后硅油对后囊膜的压迫消失，导致晶状体上皮细胞从赤道部更容易、更快地迁移到中央，形成早期PCO。晶状体上皮细胞沿前玻璃体膜增生也可能导致复发。该病例突出了视轴再次混浊这种罕见情况，因此对住院医师和实习医生具有教学价值，应让他们了解这种情况。在进行此类复杂病例的YAG晶状体囊切开术时，应向患者解释这种可能性。
