title: Liquefied after cataract and its surgical treatment.
abstract: OBJECTIVE
  To describe liquefied after cataract (LAC) and its surgical management following an uneventful phacoemulsification with posterior chamber in-the-bag intraocular lens (IOL) implantation and continuous curvilinear capsulorrhexis (CCC).
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  Eleven patients with LAC, following uneventful phacoemulsification with CCC and in-the-bag IOL implantation were enrolled. After the basic slit lamp examination, each case was investigated with Scheimpflug photography and ultrasound biomicroscopy (UBM). Each case was treated with capsular lavage. Biochemical composition of the milky fluid was evaluated and ring of anterior capsular opacity (ACO) was examined under electron microscope.
  
  
  RESULTS
  All 11 cases presented with blurring of vision after 6-8 years of cataract surgery with IOL implantation. All cases had IOL microvacuoles, 360° anterior capsule, and anterior IOL surface touch along with ACO, ring of Soemmering, and posterior capsule distension filled with opalescent milky fluid with whitish floppy or crystalline deposits. Biochemically, the milky fluid contained protein (800 mg/dl), albumin (100 mg/dl), sugar (105 mg/dl), and calcium (0.13%) and was bacteriologically sterile. Histologically, the dissected ACO showed fibrous tissue. All cases were successfully treated with capsular lavage with good visual recovery and with no complication. There was no recurrence of LAC during 2 years postoperative follow-up in any of the cases.
  
  
  CONCLUSIONS
  LAC is a late complication of standard cataract surgery. It may be a spectrum of capsular bag distension syndrome (CBDS) without shallow anterior chamber and secondary glaucoma. Capsular bag lavage is a simple and effective treatment for LAC and a safe alternative to neodymium-doped yttrium aluminum garnet (Nd-YAG) capsulotomy.
authors.affiliation: Department of Cataract and Refractive Surgery, Sri Sankaradeva Nethralya, Beltola, Guwahati, Assam, India.
authors.forename: Harsha
authors.initials: H
authors.lastname: Bhattacharjee
authors.forename: Kasturi
authors.initials: K
authors.lastname: Bhattacharjee
authors.forename: Pankaj
authors.initials: P
authors.lastname: Bhattacharjee
authors.forename: Dipankar
authors.initials: D
authors.lastname: Das
authors.forename: Krishna
authors.initials: K
authors.lastname: Gogoi
authors.forename: Diyali
authors.initials: D
authors.lastname: Arati
mesh_terms: D002387:Cataract Extraction / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods*; D006801:Humans; D007910:Lenses, Intraocular / Q000009:adverse effects*; D012086:Reoperation; D013396:Suction / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome