Atlas of Ophthalmology

Capsular Contraction Syndrome (CCS) (Colour Photography)

Lens -> Postoperative Cases and Surgical Procedures
Patient: 91 years of age, male, BVAC 0.1 at OD. General Medical History: empty. Ocular Medical History: Due to cataract in 03/2013 uncomplicated phacoemulsification with insertion of a foldable hydrophilic acrylic single-piece intraocular lens which resulted in good postoperative vision. After some weeks deterioration of visual acuity. Main complaint: decrease of vision. Methods: colour photography. Findings: fibrosis as well as phimosis of the anterior capsular opening. The capsulorhexis opening is oval-shaped, reducing the best-corrected visual acuity to 0.1. Posterior capsular opacification is not present Diskussion: It was reported (1), that anterior capsular opacification (ACO) or capsular contraction syndrome (CCS) is a known complication of continuous curvilinear capsulorhexis (CCC). Histopathologic studies have shown that anterior capsular opacification is due to lens epithelial cell metaplasia. Contact with intraocular lens biomaterial causes lens epithelial cells to undergo myofibroblastic changes and to produce extracellular matrix components. Suggested risk factors for ACO and membrane growth include pseudoexfoliation syndrome, advanced age, diabetes mellitus, uveitis, myopia, pigmentary retinal degeneration, capsulorhexis size, and IOL design and material. The contraction may cause decentration of the IOL. Literature: (1) Malik A, Gupta N, Sood S. Capsular contraction syndrome following insertion of hydrophilic acrylic lens. Int Ophthalmol. 2011 Apr;31(2):121-3.

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