Early postoperative capsular block syndrome

Purpose: To report the results of early postoperative capsular block syndro me (CBS) after phacoemulsification and intraocular lens (IOL) implantation. Setting: Department of Ophthalmology, Dokuz Eylul University School of Med icine. izmir, Turkey. Methods: Thirteen eyes of 13 patients with CBS who had uneventful phacoemul sification were included in the study. Twelve patients had in-the-bag impla ntation of a foldable IOL, and 1 had implantation of a poly(methyl methacry late) IOL in the ciliary sulcus. Continuous curvilinear capsulorhexis was p erformed in all eyes, and sodium hyaluronate 1.4% (Healon GV (R)) was used during ail steps of surgery. The patients were closely followed without int ervention during the first month after surgery. If resolution did not occur during follow-up, a neodymium:YAG (Nd:YAG) laser peripheral anterior capsu lotomy was performed first, followed by posterior capsulotomy if the anteri or capsulotomy was not successful. Results: The CBS resolved without intervention in 2 eyes by 1 month postope ratively. A small Nd:YAG laser peripheral anterior capsulotomy was attempte d in 10 cases after 1 month but could not be performed in 2 eyes because of inadequate pupil dilation. Peripheral anterior capsulotomy was successful in 5 of 8 eyes, with resolution of CBS in a few days. The Nd:YAG laser post erior capsulotomy was successful in 5 cases after the failure of the anteri or capsulotomy. One patient chose to postpone treatment for 11 months, at w hich time posterior capsulotomy was performed successfully and the CBS reso lved. Conclusions: Resolution of CBS occurred spontaneously in only a small perce ntage of cases during the first month after phacoemulsification with IOL im plantation. Neodymium:YAG laser peripheral anterior capsulotomy and posteri or capsulotomy were successful in treating CBS.