Analysis of liquid accumulated in the distended capsular bag in early postoperative capsular block syndrome

Purpose: To analyze the transparent liquid between the posterior lens capsu le and the posterior chamber intraocular lens (PC IOL) in early postoperati ve capsular block syndrome and discuss the mechanism of posterior capsule d istention. Setting: Department of Ophthalmology, Tokyo University School of Medicine, and Tokyo,Research Institute, Seikagaku Corporation, Tokyo, Japan. Methods: This study evaluated 3 cases of capsular block syndrome presenting with,transparent liquid in the distended capsular bag 1 day after cataract surgery. The transparent liquid material between the posterior capsule and PC IOL was aspirated and analyzed using high-performance liquid chromatogr aphy (HPLC). Also, sodium hyaluronate was diluted using a dialyzer to deter mine whether the aqueous humor was drawn into the capsular bag by an osmoti c gradient across the capsule. Results: The elution time of the samples was almost the same as that of sod ium hyaluronate 1.0% (Healon(R)) The concentration of the samples ranged fr om 3.29 to 9.01 mg/mL by HPLC analysis. The sodium hyaluronate absorbed the physiological salt solutions through the dialyzer and expanded to 1.9 time s its original volume. Conclusions: These results indicate that the main ingredient of the transpa rent liquid in capsular bags is sodium hyaluronate and that the distention is caused by aqueous humor being drawn into the capsular bag by an osmotic gradient across the capsule when the capsulorhexis diameter is smaller than that of the PC IOL and by viscoelastic material retained and trapped in th e bag intraoperatively. J Cataract Refract Surg 2000; 26:420-425 (C) 2000 A SCRS and ESCRS.