Ocular and Systemic Pseudoexfoliation Syndrome

Pseudoexfoliation syndrome for the comprehensive ophthalmologist. Intraocular and systemic manifestations.

Capsule contraction syndrome is an exaggerated reduction in anterior capsulectomy and capsular bag diameter after extracapsular cataract surgery. While rarely seen with can-opener-style capsulectomies with anterior radial capsular tears, it is relatively frequent with capsulorhexis. It is particularly common in patients with pseudoexfoliation and in eyes with a history of moderately severe uveitis. Its effects, which include extreme reduction in the capsulectomy opening, malposition of the opening, reduction in equatorial capsular diameter, and displacement of the IOL, seem more exaggerated in small capsulorhexis openings and in the older patient. Neodymium:YAG laser radial anterior relaxing capsulotomies done within three weeks of cataract surgery reduce the sphincter effect of the contraction and lessen the chronic zonular-traction-related complications of the condition, which may include spontaneous IOL dislocation and retinal detachment.

Daniel H. Wissinger

Papers

Risk Factors for Intraoperative Complications in 1000 Extracapsular Cataract Cases