Analysis of liquid accumulated in the distended capsular bag in early postoperative capsular block syndrome.
OBJECTIVE
To analyze the transparent liquid between the posterior lens capsule and the posterior chamber intraocular lens (PC IOL) in early postoperative capsular block syndrome and discuss the mechanism of posterior capsule distention.


METHODS
Department of Ophthalmology, Tokyo University School of Medicine, and Tokyo Research Institute, Seikagaku Corporation, Tokyo, Japan.


METHODS
This study evaluated 3 cases of capsular block syndrome presenting with transparent liquid in the distended capsular bag 1 day after cataract surgery. The transparent liquid material between the posterior capsule and PC IOL was aspirated and analyzed using high-performance liquid chromatography (HPLC). Also, sodium hyaluronate was diluted using a dialyzer to determine whether the aqueous humor was drawn into the capsular bag by an osmotic gradient across the capsule.


RESULTS
The elution time of the samples was almost the same as that of sodium hyaluronate 1.0% (Healon) The concentration of the samples ranged from 3.29 to 9. 01 mg/mL by HPLC analysis. The sodium hyaluronate absorbed the physiological salt solutions through the dialyzer and expanded to 1. 9 times its original volume.


CONCLUSIONS
These results indicate that the main ingredient of the transparent liquid in capsular bags is sodium hyaluronate and that the distention is caused by aqueous humor being drawn into the capsular bag by an osmotic gradient across the capsule when the capsulorhexis diameter is smaller than that of the PC IOL and by viscoelastic material retained and trapped in the bag intraoperatively.
Sugiura
T
T
Nihonmatsu Eye Hospital (Sugiura), Tokyo, Japan.
Miyauchi
S
S
Eguchi
S
S
Obata
H
H
Nanba
H
H
Fujino
Y
Y
Masuda
K
K
Akura
J
J
D000368:Aged; D001082:Aqueous Humor / Q000737:chemistry / Q000502:physiology*; D002387:Cataract Extraction / Q000009:adverse effects*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000032:analysis; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D007905:Lens Diseases / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D007910:Lenses, Intraocular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009995:Osmosis; D013577:Syndrome
D006820:Hyaluronic Acid