Tractional ciliary body detachment, choroidal effusion, and hypotony caused by severe anterior lens capsule contraction following cataract surgery
- Department of Ophthalmology, Aberdeen Royal Infirmary, Grampian University Hospitals
- Aberdeen, UK
- Accepted for publication 4 April 2001
Editor,—Continuous curvilinear capsulotomy (CCC) first described by Gimble and Neuhann1 has become the procedure of choice for cataract extraction by phacoemulsification. Untoward effects of capsulorhexis have not been frequently noted. Davidson first described capsular contraction syndrome as an exaggerated reduction in anterior capsulectomy and capsular bag diameter after cataract surgery.2 This specific clinical entity of “capsular contraction syndrome” is usually associated with a reduction in the capsular opening, malposition of the opening, reduction in the equatorial capsular diameter, and possibly intraocular lens (IOL) displacement.
Tractional ciliary body detachment and associated hypotony is an uncommon complication of severe anterior lens capsular contraction. Only three such cases have been reported in the literature.3 4 We report a case of tractional ciliary body detachment caused by a severe anterior lens capsule fibrosis, in which Nd:YAG laser anterior capsulotomy was effective in relieving the traction caused by the capsular contraction. We illustrate the value of ultrasound biomicroscopy (UBM) in the diagnosis and management of such conditions.
CASE REPORT
A 72 year old woman with primary open angle glaucoma and previous bilateral trabeculectomies (performed twice in the left eye) was followed up in our clinic since December 1999 for an ischaemic central vein occlusion in her right eye. She had a dense cataract in her left eye, which prevented the view of the fundus. The biometry of the left eye showed an axial length of 22.60 mm. Preoperatively intraocular pressures were 15 mm Hg in both eyes. She underwent an uncomplicated phacoemulsification through a superotemporal limbal wound. A capsulorhexis of about 5 mm was …
