Clinical case of visual axis opacification after primary posterior capsulorhexis

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Abstract

The formation of posterior continuous capsulorhexis during cataract removal has traditionally been used to prevent visual axis opacification. According to the current literature, closure of the posterior capsulorhexis opening in our patient's case should not have developed in a period of 1 year, but it did in only one of the two eyes, despite the presence of equal conditions — the same surgeon, the same IOL (sharp-edged hydrophilic acrylic with hydrophobic coating), no concomitant eye diseases and somatic pathology. We conducted a literature search to find the cause of the unilateral development of this complication, as well as the optimal treatment method. The difference between two surgeries was in the diameter of the anterior and posterior capsulorhexis — on the right eye they were 0.5–1.0 mm larger than on the left eye, and the left eye has developed opacity, which required surgery. An effective and safe way of treating this problem is the capsulotomy using a 25 gauge-vitreotome. The clinical case shows the need for further research on this topic, as formation of posterior continuous capsulorhexis has a risk of intra- and postoperative complications, and more data should be considered to ensure that there is no such recurrence of opacity.

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About the authors

Iuliia V. Bantsykina

Samara State Medical University

Author for correspondence.
Email: junessa91@mail.ru
ORCID iD: 0000-0003-3524-2328

PhD Stud., Depart. of Eye Diseases

Russian Federation, Samara, Russia

Igor V. Malov

Samara State Medical University

Email: ivmsamara@gmail.com
ORCID iD: 0000-0003-2874-9585

M.D., D. Sci. (Med.), Prof., Head of Depart. of Eye Diseases

Russian Federation, Samara, Russia

Irina I. Shteyner

Regional Medical Center

Email: iishte@yandex.ru
ORCID iD: 0000-0001-5891-6255

M.D., Cand. Sci. (Med.), Ophthalmologist

Russian Federation, Samara, Russia

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Supplementary files

Supplementary Files
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1. Fig. 1. Patient's right eye, posterior capsulorhexis, rounded. The optical zone is transparent

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2. Fig. 2. Patient's left eye, posterior capsulorhexis, rounded. Elschnig cells on the back of the IOL

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3. Fig. 3. Left eye of patient after surgical aspiration of Elschnig cells

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