Early postoperative capsular block syndrome related to saccadic-eye-movement-induced fluid flow into the capsular bag

Purpose: To determine the relationship between saccadic eye movements and t he development of early postoperative capsular block syndrome. Setting: Fundacion Oftalmologica, Los Andes, Santiago, Chile. Methods: An artificial experimental setup was designed to reproduce the ana tomical, hydrodynamic, and kinetic conditions of an early postoperative pse udophakic eye with a capsulorhexis and intracapsular intraocular lens (IOL) implantation. An electromechanical transducer driven by a digital-to-analo g converter was used to mimic saccadic eye movements at physiological speed s and accelerations. Position information and differential pressure measure ments between the intracapsular space and the extracapsular space were digi tized. Various anterior capsule-IOL configurations were tested including pa rtial adhesion of the anterior capsule to the lens. Results: Saccadic movements increased intracapsular pressure by displacing fluid into the capsular bag. This finding was inconstant and only observed when the capsular rim adhered to the IOL optic by more than 70%. Developmen t of positive intracapsular pressure was noted above 4 mm Hg. Conclusion: A valve-like mechanism formed by the capsulorhexis rim partiall y adhered to the IOL optic can occur postoperatively. Under these condition s, saccadic eye movement can increase intracapsular pressure by a unidirect ional inertial displacement of fluid into the capsular bag. J Cataract Refr act Surg 2000; 26:415-419 (C) 2000 ASCRS and ESCRS.