Anterior capsule contraction with foldable silicone intraocular lenses.

PURPOSE: To examine the causes signs, and symptoms of anterior capsule contraction syndrome and the response to neodymium YAG (Nd:YAG) anterior capsulotomy.

SETTING

Madigan Army Medical Center, Tacoma, Washington, USA.

METHODS

This retrospective review comprised 70 cases of phacoemulsification with foldable plate-haptic silicone intraocular lens (IOL) implantation. Patients who developed anterior capsule contraction postoperatively, defined as the anterior capsule being visible through an undilated pupil, had a radial anterior capsulotomy with an Nd:YAG laser. Variables analyzed were visual acuity, subjective complaints, associated inflammation, and IOL decentration.

RESULTS

Ten eyes of 9 patients (14%) developed anterior capsule contraction and had Nd:YAG laser radial anterior capsulotomy. Three of 9 patients reported decreased visual acuity and glare. Two other patients had chronic anterior chamber inflammation unresponsive to steroids after surgery that resolved after Nd:YAG anterior capsulotomy. Intraocular lens decentration was observed in 3 patients before the Nd:YAG capsulotomy. Posterior lens dislocation occurred in 1 patient after capsulotomy and required surgical lens exchange.

CONCLUSION

One-piece foldable silicone IOLs may not provide enough peripheral capsule expansion.