Taipei Veterans General Hospital Yuanshan and Suao Branch, Yilan, Taiwan, ROC.
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2022 Jul 1;85(7):799-803. doi: 10.1097/JCMA.0000000000000742. Epub 2022 Jun 30.
Late capsular blockage syndrome (CBS) is a rare phenomenon which is found after cataract surgery. The mechanism, anterior segment optical coherence tomography (OCT) presentation, and clinical characteristics are not well studied.
We studied patients who developed late CBS in Taipei Veterans General Hospital from 2012 to 2019. Age, sex, systemic disease, ocular disease, interval between cataract surgery and CBS, axial length, type of intraocular lens implanted, grading of posterior capsular opacity, refraction, visual acuity, and anterior segment OCT findings were documented. Patients are categorized into two groups according to anterior segment OCT findings. All patients underwent Nd:YAG laser capsulotomy and were prescribed a low-dose topical steroid for 7 days. Postcapsulotomy refraction and visual acuity were recorded. All the clinical data were compared in the two groups.
This study included 18 eyes with late CBS. Patients' median age was 80 (range, 54-92) years. The mean duration between cataract surgery and CBS diagnosis was 80.28 (range 15-136) months. According to anterior segment OCT findings, we subcategorized the patients into two groups: gravel appearance (n = 7) and milky (n = 11) appearance. After laser capsulotomy, mean visual acuity improved 0.18 ± 0.10 on the LogMAR. A significant myopic shift in refraction after laser capsulotomy was noted in the gravel appearance group compared to the milky appearance group ( p = 0.027). No patient developed complications or needed further treatment for CBS during the median follow-up of 14.5 months (range 1-84 months).
High-resolution anterior segment OCT is useful for analyzing patients with late CBS. Our study implies that the two types of CBS presentation indicate different causes of late CBS formation, as well as distinct clinical presentation and postlaser capsulotomy refractive outcome. In addition, YAG laser capsulotomy is a safe late CBS treatment modality.
后囊膜混浊（CBS）是白内障手术后罕见的一种现象。其发病机制、眼前节光学相干断层扫描（OCT）表现和临床特征尚未得到充分研究。
我们研究了 2012 年至 2019 年在台北荣民总医院发生迟发性 CBS 的患者。记录了患者的年龄、性别、系统性疾病、眼部疾病、白内障手术与 CBS 之间的间隔时间、眼轴长度、植入的人工晶状体类型、后囊膜混浊分级、屈光度、视力和眼前节 OCT 检查结果。根据眼前节 OCT 检查结果将患者分为两组。所有患者均接受 Nd:YAG 激光后囊膜切开术，并给予低剂量局部皮质类固醇治疗 7 天。记录后囊膜切开术后的屈光度和视力。比较两组的所有临床数据。
本研究共纳入 18 只眼迟发性 CBS。患者中位年龄 80 岁（范围，54-92 岁）。白内障手术后至 CBS 诊断的平均时间为 80.28 个月（范围，15-136 个月）。根据眼前节 OCT 检查结果，我们将患者分为两组：碎石外观（n = 7）和乳白外观（n = 11）。激光后囊膜切开术后，LogMAR 视力平均提高 0.18 ± 0.10。碎石外观组激光后囊膜切开术后的屈光度明显向近视方向偏移，与乳白外观组相比差异有统计学意义（p = 0.027）。在中位随访 14.5 个月（范围，1-84 个月）期间，无患者发生 CBS 相关并发症或需要进一步治疗。
高分辨率眼前节 OCT 对视后发性 CBS 患者的分析很有用。我们的研究表明，这两种 CBS 表现提示迟发性 CBS 形成的原因不同，临床表现和激光后囊膜切开术后的屈光结果也不同。此外，YAG 激光后囊膜切开术是一种安全的迟发性 CBS 治疗方法。
