title: Late postoperative capsular block syndrome: a case series studied before and after Nd:YAG laser posterior capsulotomy.
abstract: OBJECTIVE
  To evaluate the clinical characteristics of the unusual late postoperative capsular block syndrome (CBS) and the effect of Nd:YAG laser posterior capsulotomy on visual acuity and refractive error as well as its possible complications.
  
  
  METHODS
  In this retrospective cohort study, 12 eyes of 11 patients with late CBS who had undergone Nd:YAG laser posterior capsulotomy were reviewed. A complete ophthalmic examination including Scheimpflug camera and anterior segment optical coherence tomography (AS-OCT) imaging had been performed before and after posterior capsulotomy.
  
  
  RESULTS
  The mean time between cataract surgery and posterior capsulotomy was 4.7 ± 1.5 years (range 3-9 years). Best-corrected visual acuity increased in 11 cases (91.7%). Only one eye showed a 0.5-D hyperopic shift following posterior capsulotomy. There were no postlaser complications such as increased intraocular pressure (IOP), severe inflammation, cystoid macular edema, or retinal detachment. In all patients, the posterior capsule was vaulted posteriorly and could not be seen clearly. The AS-OCT confirmed CBS in the studied cases, demonstrating a distended capsular bag. Rotating Scheimpflug imaging examination showed the white substance located behind the intraocular lens (IOL).
  
  
  CONCLUSIONS
  Late CBS is usually not accompanied by shallow anterior chamber, forward IOL displacement, or raised IOP. Nd:YAG laser posterior capsulotomy is a useful treatment and the prognosis of patients with this complication appears favorable. Furthermore, although AS-OCT measurements are easier to obtain than rotating Scheimpflug imaging examination, both are useful to visualize the distended capsular bag containing the white material and the IOL position.
authors.affiliation: Department of Ophthalmology, Policlinic Lleida, Lleida - Spain.
authors.forename: Valentín
authors.initials: V
authors.lastname: Huerva
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Sánchez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Ascaso
authors.forename: Jordi
authors.initials: J
authors.lastname: Soldevila
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007905:Lens Diseases / Q000209:etiology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects; D057852:Posterior Capsule of the Lens / Q000473:pathology / Q000601:surgery*; D064727:Posterior Capsulotomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology