title: Propionibacterium acnes in capsular bag distension syndrome.
abstract: We report a case of capsular bag distension syndrome that developed 6 years after uneventful phacoemulsification with implantation of a foldable, single-piece acrylic intraocular lens (IOL) (AcrySof MA60BM). Slitlamp microscopy revealed a deep anterior chamber with no flare or cells. The posterior capsular bag was distended by a homogeneous milky substance between the back of the IOL and the capsular bag. Using a pars plana approach, a 23-gauge bimanual capsulotomy and anterior vitrectomy were performed. Microbiological analysis revealed Propionibacterium acnes in the material inside the capsular bag. The postoperative period was uneventful. Four weeks after surgery, visual acuity was restored and there were no signs of intraocular inflammation. The origin of late capsular bag distension is not fully understood; it may involve an infectious component with propionibacteria. A surgical approach and removal of the potentially infectious material can be considered as an alternative to neodymium:YAG capsulotomy.
authors.affiliation: University Eye Hospital, Ludwig-Maximilians University, Munich, Germany. akollias@med.uni-muenchen.de
authors.forename: Aris N
authors.initials: AN
authors.lastname: Kollias
authors.forename: Michaela A
authors.initials: MA
authors.lastname: Vogel
authors.forename: Herminia M
authors.initials: HM
authors.lastname: de Kaspar
authors.forename: Carl A
authors.initials: CA
authors.lastname: Lackerbauer
authors.forename: Martin
authors.initials: M
authors.lastname: Grueterich
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000187:drug effects / Q000382:microbiology*; D007905:Lens Diseases / Q000188:drug therapy / Q000382:microbiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D011425:Propionibacterium acnes / Q000235:genetics / Q000302:isolation & purification*; D012029:Refraction, Ocular / Q000502:physiology; D013577:Syndrome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D005938:Glucocorticoids