Swept-source anterior segment optical coherence tomography in late-onset capsular block syndrome: High-resolution imaging and morphometric modifications after posterior capsulotomy

PURPOSE: To study the characteristics of late-onset capsular block syndrome (CBS) using swept- source anterior segment optical coherence tomography (AS-OCT) and assess morphometric variations after treatment with neodymium:YAG (Nd:YAG) laser posterior capsulotomy. SETTING: Ophthalmology, University of Parma, Parma, Italy. DESIGN: Case series. METHODS: Patients with late-onset CBS had an ophthalmology evaluation, including slitlamp photography and AS-OCT, before and 1 month after ND:YAG laser posterior capsulotomy. The diameter of the anterior capsulorhexis, the posterior displacement of the posterior capsule, and the anterior chamber depth (ACD) were measured using AS-OCT. Measurements before and after Nd:YAG laser posterior capsulotomy were compared using the paired t test. RESULTS: The study evaluated 6 patients. Slitlamp examination showed accumulation between the intraocular lens (IOL) and the posterior capsule of milky-white or particulate liquefied material that appeared hyperreflective on AS-OCT and caused posterior displacement of the posterior capsule (mean 1.38 mm). The diameter of the anterior capsulorhexis (mean 4.5 mm) was smaller than the IOL optic in all cases. After uneventful Nd:YAG laser posterior capsulotomy, the corrected distance visual acuity improved in all patients (P<.01). The ACD (IOL position) and refraction did not change significantly after the capsulotomy (PZ.15 and PZ.36, respectively). CONCLUSIONS: Anterior segment OCT allowed accurate imaging and measurement of anterior segment parameters in late-onset CBS. No displacement of the IOL was found after treatment with Nd:YAG laser posterior capsulotomy. Neodymium:YAG laser posterior capsulotomy was an effective and safe therapy in the 6 late-onset CBS cases.