From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (Culp, Qu, Mamalis, Werner); Jones Eye Clinic, Sioux City, Iowa (Jones); Advanced Vision Care, Los Angeles, California (Fram, Masket); Eye Associates of New Mexico, Albuquerque, New Mexico (Ogawa).
J Cataract Refract Surg. 2022 Feb 1;48(2):177-184. doi: 10.1097/j.jcrs.0000000000000742.
To describe the findings of a recently described syndrome, the dead bag syndrome, in which the capsular bag appears to be clear many years postoperatively, becoming diaphanous and floppy and unable to support the intraocular lens (IOL) within it.
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
Case series with clinicopathological correlation.
Of 10 cases suspected to represent a dead bag syndrome, 8 IOLs and 7 capsular bags were removed because of subluxation or dislocation. The 7 capsular bags available for analysis were fixed in formalin and submitted to histopathological examination (hematoxylin-eosin and Masson trichrome stains). The associated explanted IOLs in 5 cases were also examined microscopically.
Histopathologic examination of the 7 capsular bags showed capsular thinning and/or splitting. Lens epithelial cells (LECs) were completely absent on 2 specimens, whereas the other 5 specimens had rare LECs on the inner surface of the capsule. Explanted IOLs were 3-piece silicone IOLs or single-piece hydrophobic acrylic IOLs. 1 IOL optic showed a small amount of granular pigment deposition, but the optics of the other 4 IOLs were unremarkable.
In this syndrome, there seems to be an absence of secondary proliferation of LECs and fibrotic changes. The capsule shows some signs of degradation, such as thinning and/or splitting. Weakness of zonular attachments seems to be an associated finding, with subsequent in-the-bag IOL dislocation. Further studies are necessary to ascertain the etiology of this condition.
描述一种新描述的综合征——“死袋综合征”的发现，该综合征术后多年表现为囊袋清晰，变得透明且松软，无法支撑其中的人工晶状体（IOL）。
犹他州盐湖城犹他大学约翰·A·莫兰眼中心。
病例系列并进行临床病理相关性分析。
在 10 例疑似“死袋综合征”的病例中，有 8 个 IOL 和 7 个囊袋因半脱位或脱位而被取出。对 7 个可用于分析的囊袋进行固定在福尔马林并进行组织病理学检查（苏木精-伊红和 Masson 三色染色）。在 5 例中还检查了相关的取出的 IOL 进行显微镜检查。
7 个囊袋的组织病理学检查显示囊袋变薄和/或分裂。2 个标本完全没有晶状体上皮细胞（LEC），而另外 5 个标本的囊袋内表面仅有少数 LEC。取出的 IOL 是 3 件式硅胶 IOL 或单件式疏水性丙烯酸 IOL。1 个 IOL 光学镜表现出少量颗粒状色素沉着，但其他 4 个 IOL 光学镜无明显异常。
在这种综合征中，似乎没有 LEC 的继发增殖和纤维化改变。囊袋显示出一些降解的迹象，如变薄和/或分裂。悬韧带的附着薄弱似乎是一个相关的发现，随后出现 IOL 在囊袋内脱位。需要进一步的研究来确定这种情况的病因。
