title: Anterior chamber depth and refractive change in late postoperative capsular bag distension syndrome: a retrospective analysis.
abstract: OBJECTIVE
  To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS).
  
  
  METHODS
  Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD) were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA) were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes.
  
  
  RESULTS
  Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00-0.90). ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034), equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D) and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068).
  
  
  CONCLUSIONS
  Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS.
authors.affiliation: Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Min Kyu
authors.initials: MK
authors.lastname: Yang
authors.affiliation: Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Won Ryang
authors.initials: WR
authors.lastname: Wee
authors.affiliation: Department of Ophthalmology, Myongji Hospital, Kwandong University College of Medicine, Goyang-Si, Gyeonggi, Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Han
mesh_terms: D000368:Aged; D000867:Anterior Chamber / Q000502:physiology* / Q000601:surgery*; D005131:Eye Injuries / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000503:physiopathology; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007910:Lenses, Intraocular / Q000009:adverse effects; D008297:Male; D033401:Microscopy, Acoustic / Q000379:methods; D009216:Myopia / Q000503:physiopathology / Q000601:surgery; D018918:Phacoemulsification / Q000009:adverse effects; D011184:Postoperative Period; D012029:Refraction, Ocular / Q000502:physiology*; D054140:Refractive Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*